Leptomeningeosis leucaemica in connection with acute lymphatic leukemia. A case report

MRI is significantly better than CT for detection of leptomeningeosis leucaemica, due to better imaging of the anatomy and the diversity of the tomographic images. Based on the MRI information in the case reported, the decision was for radiotherapy of the cranium: Linear accelerator-based irradiation of the neurocranium up to and inclusive of C2, with 6 MeV photons via laterally opposing fields. The single dose was 1.50 Gy, and 16.50 Gy at the reference point at the time of a control examination. The radiotherapy was accompanied at the same time by a further intrathecal cytostasis. The treatment rapidly achieved improvement of the clinical findings, and the follow-up MRI correspondingly revealed almost complete remission of the leptomeningeal foci. (orig./CB)