Many faces of meningeal carcinomatosis - a single-center case series of patients diagnosed in a neurological department setting.

Background: Meningeal carcinomatosis is a rare neurological complication of cancer, but one associated with extremely poor prognosis. The aim of this study was to analyse the incidence, clinical presentations and in-hospital outcomes of patients with meningeal carcinomatosis requiring hospitalization in a neurological department. Materials and methods: We retrospectively analyzed medical files of all patients hospitalized in neurological departments of the University Hospital in Kraków (Poland) from January 2022 to March 2024. To the study we included all patients with meningeal carcinomatosis diagnosed based on neuroimaging results and/or cerebrospinal fluid testing. Their symptoms, underlying malignancy type, auxiliary test results and in-hospital outcomes are presented in the form of a case series. Among 4056 patients hospitalized in neurological departments in the analysed period of time, 200 (4.9%) had active cancer (AC) and 6 (0.15% of all patients and 3% of AC) had a diagnosis of meningeal carcinomatosis (MC). Results: The patients were aged 41-72 with a median age of 57 years. They were all female. The most common underlying malignancy was breast cancer found in 75%. Each patient had a completely different clinical picture. Conclusions: MC is a fatal entity, clinically heterogeneous and rarely diagnosed in a neurological department setting. Nevertheless, in the context of potential treatment options, neurologists should be aware of its symptoms and signs and, being aware of the flaws of auxiliary testing, include it in the differential diagnosis, especially in patients with AC and new-onset neurological symptoms.