Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Exp Med. Mar 20, 2026; 16(1): 117938
Published online Mar 20, 2026. doi: 10.5493/wjem.v16.i1.117938
Published online Mar 20, 2026. doi: 10.5493/wjem.v16.i1.117938
Melanoma leptomeningeal disease: Advances in diagnosis and emerging therapeutic strategies
Michael L Middleton, College of Medicine, University of Florida, Gainesville, FL 32610, United States
Brandon Lucke-Wold, Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL 32610, United States
Author contributions: Middleton ML conducted the literature review and contributed to writing manuscript; Lucke-Wold B supervised the project, contributed to the conceptual framing, and revised the manuscript; and all authors have approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Brandon Lucke-Wold, MD, PhD, Department of Neurosurgery, College of Medicine, University of Florida, 1104 Newell Drive, Unit 210, Gainesville, FL 32610, United States. brandon.lucke-wold@neurosurgery.ufl.edu
Received: December 18, 2025
Revised: January 12, 2026
Accepted: February 3, 2026
Published online: March 20, 2026
Processing time: 86 Days and 15.1 Hours
Revised: January 12, 2026
Accepted: February 3, 2026
Published online: March 20, 2026
Processing time: 86 Days and 15.1 Hours
Core Tip
Core Tip: Melanoma leptomeningeal disease (LMD) is the most severe complication of advanced melanoma, characterized by very poor outcomes and a lack of robust evidence to inform management. This narrative review synthesizes recent advances in the understanding of LMD biology, highlights the clinical significance of evolving diagnostic strategies including neuroimaging and cerebrospinal fluid-based assays, and reviews emerging therapeutic approaches. The article contrasts LMD with parenchymal brain metastases, identifies ongoing clinical challenges, and notes key research priorities needed to improve outcomes for this historically understudied condition.