Leptomeningeal metastases
Three tissue layers (meninges) cover the brain and spinal cord. The two inner layers are called the leptomeninges. Between the two layers is a space filled with
The third, thicker, outer layer is called the dura mater.
Leptomeningeal are also called:
carcinomatosis meningitis
leptomeningeal disease
leptomeningeal carcinomatosis
neoplastic meningitis
Cancer cells can reach the meninges by:
travelling in the bloodstream from a cancer somewhere else in the body
spreading from a secondary cancer (metastases) that has already developed in the brain
A secondary cancer happens when:
cancer cells break away from where the cancer first started (the primary cancer)
spreads to another part of the body
Around 5 out of every 100 people (5%) with advanced cancer might have leptomeningeal metastases. It is most common in people with breast or lung cancer or melanoma skin cancer. In people with blood cancer, 5 to 15 out of every 100 people (5 to 15%) might develop leptomeningeal metastases.
Speak to your cancer specialist or specialist nurse if you are worried about this.
Cancer cells in the covering of the brain can cause a range of symptoms, including:
headaches
changes to your sight, such as double vision or loss of sight
confusion
weakness
seizures (fits)
feeling sick (nausea)
vomiting
hearing changes
facial drooping
pain in your lower back, legs or neck
mental changes such as mood and behaviour
changes to how you walk
numbness or weakness of one or both legs and of your bottom
problems peeing or pooing
Leptomeningeal metastases can be difficult to diagnose. It might show up on an MRI scan. It may also show up in cerebrospinal fluid collected through a lumbar puncture.
A lumbar puncture tests the cerebrospinal fluid (CSF). CSF circulates around the brain and spinal cord.
Read about the different cancer tests
Depending on where the cancer started, treatment might include :
chemotherapy
targeted cancer drugs
immunotherapy
radiotherapy
Some people may not be able to have treatment for their cancer because they are too unwell. You will have medicine to control any pain or other side effects you may be getting.
Find out about treating leptomeningeal metastases
Most people worry about their outlook (prognosis) when they have a secondary cancer. Your individual outlook depends on many factors, including:
whether the cancer has spread to more than one part of your body
how quickly it is growing
how it responds to treatment
Treatment for leptomeningeal metastases aims to:
control the growth of the cancer
relieve symptoms
Treatment may control cancer cells in the meninges for some months. With newer cancer drugs, this might possibly be longer for certain cancers.
It is not always possible for doctors to predict someone’s outlook. This uncertainty can be hard to deal with. But support is available.
Last reviewed: 21 Oct 2026
Next review due: 21 Oct 2029
Doctors are still looking at which treatments work best for treating leptomeningeal metastases. Treatment generally includes chemotherapy, targeted cancer drugs or radiotherapy.
A primary cancer is where a cancer starts. Sometimes cancer cells can break away from the primary cancer and settle and grow in another part of the body. This new cancer growth is called secondary cancer.
Find out about tests to diagnose cancer and monitor it during and after treatment, including what each test can show, how you have it and how to prepare.
Coping with cancer can be difficult. There is help and support available. Find out about the emotional, physical and practical effects of cancer and how to manage them.
Leptomeningeal metastases mean cancer cells have spread to one of the membranes that surround the brain.
Search for the cancer type you want to find out about. Each section has detailed information about symptoms, diagnosis, treatment, research and coping with cancer.
