Leptomeningeal carcinomatosis: easy to miss

Leptomeningeal carcinomatosis is a devastating condition with very poor prognosis. With advances in cancer treatment leading to improved survival in solid tumours, the incidence of ante-mortem diagnosis of leptomeningeal carcinomatosis is likely to rise. Without a high index of suspicion and appropriate imaging the diagnosis can be missed. We report two cases of leptomeningeal carcinomatosis secondary to metastatic breast disease with varied clinical presentation where the diagnosis was initially missed.