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J Korean Soc Emerg Med > Volume 23(5); 2012 > Article
Journal of The Korean Society of Emergency Medicine 2012;23(5): 637-642.
Survival in Neoplastic Meningitis as a Function of Diagnostic Modalities
Youn Jung Kim, Shin Ahn, Kyung Soo Lim, Jae Lyun Lee
1Department of Emergency Medicine, Cancer Emergency Room, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. ans1023@gmail.com
2Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Neoplastic meningitis (NM) is diagnosed by the presence of malignant cells within cerebrospinal fluid (CSF), or brain and spinal cord imaging with magnetic resonance imaging (MRI). Patients with NM were divided into three diagnostic subcategories, and overall survival as a function of diagnostic modalities was analyzed.
A total of 150 patients with a solid tumor or lymphoma diagnosed as NM in an emergency department between 2003 and 2010 were included. Patients were divided into three groups: positive cytology and MRI (n=64), positive cytology with negative MRI (n=43), and negative cytology with positive MRI (n=43).
Overall median survival from NM was eight weeks. CSF was positive for malignant cells in 107(71.3%) patients, and MRI was positive in 107(71.3%) patients. Survival did not vary significantly among the three groups [CSF(+), MRI(-): median 12 weeks, range 1-80(95% CI, 7-17); CSF(-), MRI(+): median 12 weeks, range 1-66 (95% CI, 7-17); CSF(+), MRI(+): median 6 weeks, range 1-64(95% CI, 3-9), p=0.306].
When considering diagnostic modalities, examination of CSF and MRI showed the same sensitivities, and the survival of NM was similar in patients with different diagnostic modalities.
Key words: Meningeal Carcinomatosis, Diagnosis, Magnetic Resonance Imaging, Neoplasms
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