Chemical tumor meningitis

Chemical tumor meningitis is defined here as meningeal inflammation secondary to the release of the contents of a cystic tumor into the subarachnoid spaces.

The primary tumors found are usually benign (e.g. (epi)-dermoid cysts, craniopharyngiomas, etc.).

The clinical picture is dominated by a meningeal syndrome and frequently spinal pain associated with bilateral or tilting radicular pain. Fatal cases have been described, but are considered exceptional. It may evolve as a chronic or acute recurrent disease.

Examination of cerebrospinal fluid (CSF) under polarized light may reveal keratin debris and/or cholesterol crystals, sometimes with elevated proteinorachy. Cerebral MRI usually reveals the causative lesion.

Prognosis and treatment depend on the nature of the tumour (simple excision in the case of benign tumours).

Author(s)

Dr Shanan Khairi, MD

Bibliography

Bradley WG et al., Neurology in clinical practice, 5th ed., Butterworth-Heinemann, e-dition, 2007

Cambier J et al., Neurologie, 13e édition, Masson, 2012

Osborn AG, Diagnostic imaging : brain, Amirsys, USA, 2d ed., 2009

Pradat PF, Méningites chroniques, Encycl Méd Chir (Elsevier), Neurologie, 17-160-C-30, 2002