Evaluation and Workup of Leptomeningeal Disease

Leptomeningeal disease (LMD) is a devastating complication of cancer and a challenge to treat. This chapter addresses the evaluation and workup of LMD. Since a timely diagnosis can make a difference in the patient’s function and quality of life, it is imperative to be aware of the clinical presentation and diagnostic evaluation of LMD as it is a disease that can easily be missed. Neuroimaging and cerebrospinal fluid (CSF) analysis are the main diagnostic methods. Neuroimaging is more sensitive, whereas CSF analysis is more specific and together can bridge the gap in the diagnosis of LMD.