Leptomeningeal metastases (LM) are increasingly recognized as a devastating complication of solid tumors. Improved treatment of primary malignancy and advances in diagnostic imaging have led to an apparent increase in the number of patients diagnosed with LM. Unfortunately, therapeutic options remain limited. Radiotherapy is used to treat bulky tumor and provide symptomatic relief. Intrathecal chemotherapy benefits a selected subset of patients. Given that LM is a cancer complication that can spread throughout the entire subarachnoid space, chemotherapy, whether intrathecal or systemic, is currently considered the best treatment option, when feasible.
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