Computed Tomography in Cerebral Malignant Disease

Excerpt

To the editor: In Dr. Weisberg's recent comprehensive review of computed tomography (CT)(1), two areas were not addressed in regard to malignant disease—leptomeningeal carcinomatosis and progressive multifocal leukoencephalopathy. Both may mimic neurologic disorders and are frequently difficult diagnoses to establish (2-5).

There is little in the literature on the usefulness of CT scanning in diagnosing leptomeningeal carcinomatosis, but a recent report noted that computed tomography detected intracranial meningeal spread in 44% of these patients (6). The characteristic finding was subarachnoid contrast enhancement, and in two patients this finding was the first suggestion of the process.

Progressive multifocal leukoencephalopathy is a