{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T17:49:18Z","timestamp":1759600158327},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,7,6]],"date-time":"2019-07-06T00:00:00Z","timestamp":1562371200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Leptomeningeal dissemination (LD) in adults is an exceedingly rare complication of low-grade neuroepithelial CNS tumors (LGNs). We aimed to determine relative incidence, clinical presentation, and predictors of outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched the quality control database of the Section of Neuro-Oncology, Yale Cancer Center, for patients with LGN (WHO grade I\/II) seen between 2002 and 2017. For cases complicated by LD, we recorded demographics, clinical signs, histopathological diagnosis, and imaging findings. A comprehensive literature review was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eleven consecutive patients with LD were identified, representing 2.3% of individuals with LGN seen at our institution between 2002 and 2017 (n = 475). Ependymoma was the predominant histological entity. Mean time interval from diagnosis of LGN to LD was 38.6 \u00b1 10 months. Symptoms were mostly attributed to communicating hydrocephalus. Tumor deposits of LD were either nodular or linear with variable enhancement (nonenhancing lesions in 4 of 11 patients). Localized (surgery, radiosurgery, involved-field, or craniospinal radiation therapy) or systemic treatments (chemotherapy) were provided. All patients progressed radiographically. Median overall survival after LD was 102 months. Survival was prolonged when a combination of localized and systemic therapies was administered (188.5 vs 25.5 months; P = .03). Demographics and tumor spectrum reported in the literature were similar to our cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>LD is a rare complication of LGNs. A high level of suspicion is required for timely diagnosis as early symptoms are nonspecific and commonly do not occur until years after initial tumor diagnosis. Repeated aggressive treatment appears to be beneficial in improving survival.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/nop\/npz020","type":"journal-article","created":{"date-parts":[[2019,7,6]],"date-time":"2019-07-06T08:02:52Z","timestamp":1562400172000},"page":"118-126","source":"Crossref","is-referenced-by-count":3,"title":["Leptomeningeal dissemination of low-grade neuroepithelial CNS tumors in adults: a 15-year experience"],"prefix":"10.1093","volume":"7","author":[{"given":"Philipp","family":"Karschnia,","sequence":"first","affiliation":[{"name":"Department of Neurology, Yale School of Medicine, New Haven, CT, USA"},{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank J","family":"Barbiero","sequence":"first","affiliation":[{"name":"Department of Neurology, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michaela H","family":"Schwaiblmair","sequence":"first","affiliation":[{"name":"Department of Neurology, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leon D","family":"Kaulen","sequence":"first","affiliation":[{"name":"Department of Neurology, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph M","family":"Piepmeier","sequence":"first","affiliation":[{"name":"Department of Neurology, Yale School of Medicine, New Haven, CT, USA"},{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita J","family":"Huttner","sequence":"first","affiliation":[{"name":"Department of Pathology, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin P","family":"Becker","sequence":"first","affiliation":[{"name":"Department of Neurology, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert K","family":"Fulbright","sequence":"first","affiliation":[{"name":"Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim M","family":"Baehring","sequence":"first","affiliation":[{"name":"Department of Neurology, Yale School of Medicine, New Haven, CT, USA"},{"name":"Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,7,6]]},"reference":[{"key":"2020033011550308800_CIT0001","doi-asserted-by":"crossref","first-page":"v1","DOI":"10.1093\/neuonc\/now207","article-title":"CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2009-2013","volume":"18","author":"Ostrom","year":"2016","journal-title":"Neuro Oncol"},{"key":"2020033011550308800_CIT0002","doi-asserted-by":"crossref","first-page":"17758","DOI":"10.1038\/srep17758","article-title":"Surgical ventricular entry is a key risk factor for leptomeningeal metastasis of high grade gliomas","volume":"5","author":"Roelz","year":"2015","journal-title":"Sci Rep."},{"issue":"4","key":"2020033011550308800_CIT0003","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1227\/00006123-198910000-00005","article-title":"Cerebral glioblastoma with cerebrospinal fluid dissemination: a clinicopathological study of 14 cases examined by complete autopsy","volume":"25","author":"Onda","year":"1989","journal-title":"Neurosurgery."},{"issue":"4","key":"2020033011550308800_CIT0004","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1212\/WNL.38.4.562","article-title":"Leptomeningeal dissemination of low-grade gliomas in childhood","volume":"38","author":"Civitello","year":"1988","journal-title":"Neurology."},{"issue":"9-10","key":"2020033011550308800_CIT0005","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/0360-3016(77)90181-X","article-title":"Medulloblastoma in children: a correlation between staging and results of treatment","volume":"2","author":"Harisiadis","year":"1977","journal-title":"Int J Radiat Oncol Biol Phys."},{"issue":"2","key":"2020033011550308800_CIT0006","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1002\/mpo.2950240209","article-title":"Recommendations of the Brain Tumor Subcommittee for the reporting of trials. 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