A much-anticipated article led by Children’s Brain Tumor Project (CBTP) postdoctoral fellows Carolina Cocito and Brice Martin, with Principal Investigators Dr. Nadia Dahmane, Dr. Jeffrey Greenfield, and Dr. Mark Souweidane, and collaborators at NewYork-Presbyterian/Columbia University, was recently published in the April special issue of Neoplasia dedicated to pediatric brain tumors.
The paper, “Leptomeningeal Dissemination in Pediatric Brain Tumors,” examines the nature of leptomeningeal dissemination (LMD) across a wide range of rare pediatric brain tumor types. LMD—also known as leptomeningeal metastasis—is defined by the presence of cancer cells along the meninges, the thin layers of tissue that protect the brain and spinal cord. In children with brain tumors, LMD remains poorly understood and inconsistently classified, with incidence, prognosis, treatment, and screening practices varying widely depending on the underlying tumor type.
Although LMD is most commonly associated with medulloblastoma, it has been reported across numerous pediatric brain tumor pathologies. The article addresses this complexity in detail, highlighting how LMD may be present at initial diagnosis, at recurrence, or—more rarely—as primary disease without an identifiable primary tumor.
LMD poses a significant therapeutic challenge in nearly all pediatric brain tumors. Tumor cells that spread into the cerebrospinal fluid must adapt to a harsh, nutrient-poor, and turbulent environment, resulting in cancer cells that are often highly treatment resistant. This comprehensive review synthesizes current knowledge of LMD across pediatric brain tumors—including medulloblastoma, craniopharyngioma, atypical teratoid rhabdoid tumor (ATRT), choroid plexus tumors, diffuse midline glioma (DMG), ependymoma, germ cell tumors, and diffuse leptomeningeal glioneuronal tumors—with an emphasis on incidence, clinical presentation, and therapeutic management. The goal is to provide new insights into this particularly challenging aspect of pediatric brain cancer.
