Gambaran klinis, MRI kepala dan sitologi cairan serebrospinal pada pasien metastasis leptomeningeal
https://doi.org/10.22146/bns.v18i2.54985 Kusumo Dananjoyo(1*), Rusdy Ghazali Malueka(2), Ahmad Asmedi(3)
(1) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(2) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(3) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author
Abstract
Metastasis leptomeningeal (ML) merupakan kondisi yang berbahaya pada kasus neuroonkologi dan masih menjadi tantangan dalam diagnosis, manajemen, dan prognosis. ML merupakan salah satu komplikasi di bidang neuroonkologi namun diagnosis kasus ini masih sering tidak terdiagnosis. Insidensi ML pada tumor padat sekitar 4-5% dan mencapai 20% pada keganasan hematologi. Penegakan diagnosis ML masih menjadi tantangan karena tanda dan gejala yang tidak spesifik sedangkan imaging memiliki sensitivitas dan spesifisitas yang bervariasi.
Artikel ini bertujuan untuk memberikan informasi mengenai gambaran klinis, MRI kepala dan analisis LCS dan pemeriksaan molekuler lainnya untuk menegakkan diagnosis ML, sehingga neurologis dapat mendiagnosis ML dan melakukan pemeriksaan selanjutnya agar terapi maksimal.
Keywords
Full Text:
PDF (Bahasa Indonesia)References
1.Lombardi G, Zustovich F, Farina P, Puppa AD, Manara R, Cecchin D, et al. Neoplastic meningitis from solid tumors: new diagnostic and therapeutic approaches. Oncologist. 2011;16(8): 1175-1188.
2.Pauls S, Fischer AC, Brambs HJ, Fetscher S, Höche W, Bommer M. Use of magnetic resonance imaging to detect neoplastic meningitis: limited use in leukemia and lymphoma but convincing results in solid tumors. Eur J Radiol. 2012;81(5):974-978.
3.Wang N, Bertalan MS, Brastianos PK. Leptomeningeal metastasis from systemic cancer: Review and update on management. Cancer. 2018;124(1):21-35. Available from: doi: 10.1002/cncr.30911. Epub 2017 Nov 22.
4.Pruitt AA. CNS infections in patients with cancer. Continuum (MinneapMinn). 2012;18:384-405.
5.Gil B, Hwang E-J, Lee S, Jang J, Choi HS, Jung S-L, et al. Detection of Leptomeningeal Metastasis by Contrast-Enhanced 3D T1-SPACE: Comparison with 2D FLAIR and Contrast-Enhanced 2D T1-Weighted Images. PLoS ONE. 2016;11(10) .
6.Recht L1, Mrugala M. Neurologic complications of hematologic neoplasms. Neurol Clin. 2003;21(1):87-105.
7.Waki F, Ando M, Takashima A, Yonemori K, Nokihara H, Miyake M, et al. Prognostic factors and clinical outcomes in patients with leptomeningeal metastasis from solid tumors. J Neurooncol. 2009;93:205-212.
8.Clarke JL, Perez HR, Jacks LM, Panageas KS, DeAngelis LM. Leptomeningeal metastases in the MRI era. Neurology. 2010;74:1449-1454.
9.Del Principe MI, Maurillo L, Buccisano F, Sconocchia G, Cefalo M, De Santis G, et al. Central Nervous System Involvement in Adult Acute Lymphoblastic Leukemia: Diagnostic Tools, Prophylaxis, and Therapy. Mediterranean Journal of Hematology and Infectious Diseases. 2014;6.
10.Blumenfeld, H. Neuroanatomy Through Clinical Cases, 2nd ed. Massachusetts: Inc. Publishers Sunderland Associates Inc.; 2010; 5:134.
11.Cui JZ. Advancements in diagnosis and treatment of meningeal carcinomatosis in solid cancer. Neuroimmunol Neuroinflammation. 2017;4:167-178. 12.Diansari Y, Aninditha T, Andriani R. Karakteristik Cairan Serebrospinal Pada Keganasan Hematologi. Neurona. 2017;34(4).
13.Leal T, Chang JE, Mehta M, Robins HI. Leptomeningeal metastasis: challenges in diagnosis and treatment. Curr Cancer her Rev. 2011;7:319–327.
14.Brastianos PK, Brastianos CH, Eichler AF. Leptomeningeal Metastasis. In: Palmieri D. (eds) Central Nervous System Metastasis, the Biological Basis and Clinical Considerations. Cancer Metastasis-Biology and Treatment. 2012;18.
15.Adilistya T. Pathophysiology and Diagnosis of Acute Lymphoblastic Leukemia Infiltration to the Central Nervous System. Jurnal Kedokteran Yarsi. 2017;25(2):115-126.
16.Mastrangelo R, Poplack DG, Riccardi R. Central Nervous System Leukemia: Prevention and Treatment. Netherlands: Springer; 1983.p.1-9.
17. Rigakos G, Liakou CI, Felipe N, Orkoulas-Razis D, Razis E. Clinical Presentation, Diagnosis and Radiological Findings of Neoplastic Meningitis. Cancer Control. 2017;24:9–21. 18.Clarke JL. Leptomeningeal metastasis from systemic cancer. Continuum (Minneap Minn). 2012;18(2):328-342. 19. Gauthier H, Guilhaume MN, Bidard FC, Pierga JY, Girre V, Cottu PH, et al. Survival of breast cancer patients with meningeal carcinomatosis. Ann Oncol. 2010;21:2183-2187.
20. Morris PG, Reiner AS, Szenberg OR, Clarke JL, Panageas KS, Perez HR, et al. Leptomeningeal metastasis from non-small cell lung cancer: survival and the impact of whole brain radiotherapy. J Thorac Oncol. 2012;7:382-385.
21. Singh SK, Leeds NE, Ginsberg LE. MR Imaging of Leptomeningeal Metastases: Comparison of Three Sequences. American Journal of Neuroradiology. 2002;23(5):817-821.
22. National comprehensive cancer network. NCCN Clinical practice guidelines in oncology (NCCN Guidelinnes) Central Nervous System Cancers. Version 1. 2019. Available from: URL: http://www.nccn.org
DOI: https://doi.org/10.22146/bns.v18i2.54985
Article Metrics
Abstract views : 6010
| 
views : 8872
Refbacks
- There are currently no refbacks.
Copyright (c) 2020 Berkala NeuroSains
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.