Esin Kurtuluş ÖZTÜRK, Saffet ÖZTÜRK, Suzan SAYLISOY, Bülent YILDIZ

Leptomeningeal Metastazları; Klinik ve Manyetik Rezonans Go rü ntü leme Bülgüları

Bu çalışmada malign solid tümörlerin intrakraniyal leptomeningeal metastazlarının klinik ve manyetik rezonans görüntüleme (MRG) bulgularını literatür bilgileri eşliğinde sunmayı amaçladık. Ocak 2015 ile Nisan 2018 arasında farklı primer solid malignitelere sahip leptomeningeal metastaz tanısı olan 32 hasta çalışmaya dahil edildi. Hastaların klinik ve kontrastlı beyin MRG incelemeleri retrospektif değerlendirildi. Hastaların demografik özellikleri, primer maligniteleri, klinik ve MRG bulguları kaydedildi. MRG görüntülerde leptomeningeal metastazların lokalizasyonu ve kontrastlanma paterni, kraniyal sinir tutulumu, hidrosefali ve subependimal nodül varlığı değerlendirildi. Leptomeninkste metastazı en sık yapan malign solid tümörler akciğer (%53.1) ve meme (%25) karsinomlarıydı. En sık semptom baş ağrısı ve bilinç değişikliğiydi. Çoğunlukla infratentoryal ve supratentoryal (%50) alanların birlikte tutulumu mevcuttu. Kontrastlı MRG’de kontrastlanma çoğunlukla nodüler paternde (%53.1) izlendi. Kraniyal sinir tutulumu nadir saptanmakla birlikte en sık 7. ve 8. kraniyal sinir tutulumu mevcuttu. Hidrosefali (%43.8) ve parankimal metastaz (%87.5) sık saptandı. Leptomeningeal metastazlarda klinik ve radyolojik görüntüleme özelliklerinin bilinmesi doğru tanı, uygun tedavi ve doğru hastalık yönetimine olanak sağlar.

İntracranial Leptomeningeal Metastases of Malign Solid Tümors; Clinical and Magnetic Resonance İmaging Findings

We aimed to present clinical and magnetic resonance imaging (MRI) findings of intracranial leptomeningeal metastases of malign solid tumors with literature. Between January 2015 and April 2018, 32 patients with histopathologically proven different primary solid malignancies and diagnosis of leptomeningeal metastases were included in this study. We retrospectively analyzed the clinical and contrast-enhanced MRI findings of patients. We documented demographic characteristics, primary malignancies, clinical and MRI findings. We evaluated localization and enhancement pattern of leptomeningeal metastases, cranial nerve involvement, presence of hydrocephalus and presence of subependymal nodule on MRI. The most common malign solid tumors with leptomeningeal metastases were lung (53.1%) and breast (25%) carcinomas. The most common presenting symptoms were headache and altered consciousness. Leptomeningeal metastases were mostly located in both infratentorial and supratentorial areas (50%).On contrast-enhanced MR images nodular enhancement pattern (53.1%) was mostly observed. Although cranial nerve involvement was rarely detected, cranial nerve involvement was most frequently observed in the 7th and 8th cranial nerves. Hydrocephalus (43.8%) and parenchymal metastasis (87.5%) were quite common. Knowledge of clinical and radiological imaging features in leptomeningeal metastases allows accurate diagnosis, appropriate treatment and disease management.

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