PROLONGED SURVIVAL IN CARCINOMATOUS MENINGITIS ASSOCIATED WITH BREAST-CANCER

We describe a patient who survived for more than 7 years after the dia gnosis of meningeal carcinomatosis associated with breast cancer. Meni ngeal carcinomatosis occurs in 1% to 5% of patients with breast cancer . The median survival ranges from 3 to 7 months, but most reports incl ude a small number of patients who survive considerably longer, with u p to 11% surviving more than 1 year. Early diagnosis, aggressive treat ment of neurologic involvement, limited systemic tumor burden, and var ied rates of progression are factors that may relate to extended durat ion of survival in these patients with breast cancer. Our patient, wit h a hormonally responsive adenocarcinoma of the breast and without sys temic metastases, illustrates that meningeal carcinomatosis, like othe r forms of breast cancer metastasis, can run an indolent course. In su ch patients the delayed sequelae of therapy for metastasis to the cent ral nervous system can profoundly influence the course of the illness.