Meningeal leukemia

Case contributed by Dr Prashant Gupta


Known case of AML followed by CML with non-specific headache. A contrast-enhanced CT (not shown) was done which was reported as a falcine meningioma. MRI to further assess.

Patient Data

Age: 55
Gender: Female

Falcine meningeal thickening that is T1 isointense to grey matter. It shows minimal restricted diffusion.

Postcontrast images reveal multiple areas of meningeal thickening on both sides with extension through foramen rotundum on the left. 

Annotated image

Extension through foramen rotundum on the left. 

Case Discussion

  • meningeal leukemia occurs in up to one-third of cases with leukemia
  • more common in children than adults, especially kids with ALL who relapse after combination chemotherapy
  • more common with lymphocytic than myelogenous leukemia
  • cranial irradiation with intrathecal methotrexate is treatment of choice, however, it gives rise to a methotrexate-associated necrotizing encephalopathy in some patients
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Case information

rID: 17272
Published: 31st Mar 2012
Last edited: 13th Aug 2019
Inclusion in quiz mode: Included