Low Spinal Fluid Sugar in Meningeal Carcinomatosis

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Abstract
CARCINOMATOSIS of the meninges is a term employed by Fischer-Williams and associates 1 to describe the rare condition in which metastatic implants of neoplastic cells grow on the leptomeninges without development of a tumor. Several types of intracranial tumors (primary and metastatic) can give rise to meningeal seeding, but most are associated with actual development of a tumor. Low spinal fluid sugar, in the absence of infection of the central nervous system, appears to be the most valuable diagnostic clue of neoplastic meningeal seeding. The cerebrospinal fluid is rarely examined for malignant cells, but this examination could well increase the diagnostic accuracy of meningeal carcinomatosis as it did in the following case. Report of a Case A 63-year-old white farmer was admitted to the Ochsner Clinic on May 5, 1965, because of progressively worsening low back pain associated with bilateral sciatica of 18 months' duration. He had consulted a number

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