Treatment of Meningeal Carcinomatosis using an Ommaya Reservoir

Abstract

Meningeal carcinomatosis is an infrequent but important complication in solid tumors. The prognosis for meningeal carcinomatosis is poor, and there is no effective treatment. An Ommaya reservoir is useful to control hydrocephalus because there is no risk of malignant cells being implanted in the peritoneum as compared with a ventricular-peritoneal shunt operation. We reported 5 cases of meningeal carcinomatosis-4 lung cancer (3 smallcell carcinoma, 1 adenocarcinoma) and 1 breast cancer which were treated by the Ommaya reservoir. No case responded to lumbar Methotrexate injection. Three cases were complicated with hydrocephalus. Injection of Methotrexate or Cytosine Arabinoside into the lateral ventricle through the Ommaya reservoir had marked anti-neoplastic effects in 3 cases of small cell carcinoma. There were no significant complications using the Ommaya reservoir and injection of Methotrexate or Cytosine Arabinoside. The mean survival rate in thesereported cases was 19.2 weeks compared to 6 weeks for cases before the Ommaya reservoir was employed. We concluded that the Ommaya reservoir was effective for meningeal carcinomatosis. © 1990, The Japan Lung Cancer Society. All rights reserved.