Meningeal Carcinomatosis

We reviewed 33 cases of meningeal carcinomatosis seen at the Mount Sinai Hospital, New York, from 1970 through 1979. The major sources of meningeal disease were carcinoma of the breast (21 cases), carcinoma of the lung (five), and malignant melanoma (five). Seventy-eight percent of the patients had widespread metastases at the time of neurologic diagnosis. A combination of radiotherapy and intrathecal administration of methotrexate was the most successful treatment, and 14 of 22 treated patients showed at least symptomatic improvement; however, mean survival in the most improved group was still less than six months.