{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:44Z","timestamp":1756339544028,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,9,8]]},"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:p>A man in his mid-40s presented to hospital with confusion, headache and feeling generally unwell. He had had a total resection of a grade IV astrocytic glioma 1\u2009year prior. Initial observations, blood tests and CT head scan were unremarkable for acute features to explain the patient\u2019s presentation. However, an MRI head scan on this admission demonstrated a clear communicating hydrocephalus with new abnormal leptomeningeal enhancement, consistent with leptomeningeal metastatic infiltration by glioma. Lumbar puncture cytology and biochemistry supported this interpretation. As a small district general hospital in rural Wales, we discuss the experience of diagnosis and coordination of specialist input from a multidisciplinary team. We share the challenges of managing leptomeningeal disease in the COVID-19 pandemic, in the context of the additional risks this presents with chemotherapy-induced immunosuppression.<\/jats:p>","DOI":"10.1136\/bcr-2022-250943","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T13:10:22Z","timestamp":1663333822000},"page":"e250943","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnosis and management of leptomeningeal disease secondary to grade IV astrocytic glioma"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6037-6558","authenticated-orcid":false,"given":"Chon Meng","family":"Lam","sequence":"first","affiliation":[{"name":"Hywel Dda University Health Board, Carmarthen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Lisacek-Kiosoglous","sequence":"additional","affiliation":[{"name":"Hywel Dda University Health Board, Carmarthen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Paleacu","sequence":"additional","affiliation":[{"name":"Hywel Dda University Health Board, Carmarthen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elin","family":"Jones","sequence":"additional","affiliation":[{"name":"Hywel Dda University Health Board, Carmarthen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,9,16]]},"reference":[{"key":"2025082709150614000_15.9.e250943.1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.20272"},{"key":"2025082709150614000_15.9.e250943.2","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1227\/01.NEU.0000043929.31608.62","article-title":"Combined-modality treatment of leptomeningeal gliomatosis","volume":"52","author":"Chamberlain","year":"2003","journal-title":"Neurosurgery"},{"key":"2025082709150614000_15.9.e250943.3","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.wneu.2020.10.023","article-title":"Spinal drop metastasis of Glioblastoma-Two case reports, clinicopathologic features, current modalities of evaluation, and treatment with a review of the literature","volume":"146","author":"Pande","year":"2021","journal-title":"World Neurosurg"},{"key":"2025082709150614000_15.9.e250943.4","doi-asserted-by":"publisher","DOI":"10.4103\/2152-7806.111304"},{"key":"2025082709150614000_15.9.e250943.5","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2014.00220","article-title":"Leptomeningeal metastases in high-grade adult glioma: development, diagnosis, management, and outcomes in a series of 34 patients","volume":"5","author":"Dardis","year":"2014","journal-title":"Front Neurol"},{"key":"2025082709150614000_15.9.e250943.6","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19991001)86:7<1347::AID-CNCR34>3.0.CO;2-M"},{"key":"2025082709150614000_15.9.e250943.7","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19980215)82:4<733::AID-CNCR17>3.0.CO;2-Z"},{"key":"2025082709150614000_15.9.e250943.8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210074"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-250943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:15:12Z","timestamp":1756311312000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-250943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":8,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9,16]]},"published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1136\/bcr-2022-250943"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-250943","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,9]]}}}