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'''Associate Editor in Editor:''' {{CZ}}


==[[Intracerebral metastases overview|Overview]]==


'''Intracerebral metastasis''' accounts for approximately 25-50% of intracranial tumors in hospitalized patients. The true incidence of brain metastasis is unknown, but recent estimates are as high as 200,000 cases per year in the United States alone. 80% of brain metastases can be accounted for by five primary tumor sites: lung, breast, skin (melanoma), kidney and the gastrointestinal tract. A population-based study of 169,444 cancer patients from 1973 to 2001 in Detroit revealed that overall, 10% of patients diagnosed with one of these five primaries went on to develop brain metastases. Specifically, 19.9% of lung cancers, 6.9% of melanomas, 6.5% of renal cancers, 5.1% of breast cancers and 1.8% of colorectal cancers metastasized to the brain.
==[[Intracerebral metastases historical perspective|Historical Perspective]]==


Parenchymal blood flow is an important determinant of the distribution of metastases. 80% of metastases localize to the cerebral hemispheres, 15% localize to the cerebellum and 3% localize to the basal ganglia. Often these tumors can be found at the gray/white matter junction.
==[[Intracerebral metastases classification|Classification]]==


==Gross appearance==
==[[Intracerebral metastases pathophysiology|Pathophysiology]]==


Typically metastases are sharply demarcated from the surrounding parenchyme and usually there is a zone of peritumoral edema out of proportion with the tumor size.
==[[Intracerebral metastases causes|Causes]]==


==Microappearance==
==[[Intracerebral metastases differential diagnosis|Differentiating Intracerebral metastases from other Diseases]]==


Typically well-demarcated with the exception of melanoma metastases.
==[[Intracerebral metastases epidemiology and demographics|Epidemiology and Demographics]]==


==Radiographic findings==
==[[Intracerebral metastases risk factors|Risk Factors]]==


There is a great deal of variability in the appearance of these tumors, however some generalizations can be made.
==[[Intracerebral metastases screening|Screening]]==


===CT===
==[[Intracerebral metastases natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


'''NECT:''' Iso to hypodense mass with anywhere from zero to marked peritumoral edema.
==Diagnosis==


'''CECT:''' enhancement is also variable and can be intense, punctuate, nodular or ring-enhanced if the tumor has out grown it's blood supply.
[[Intracerebral metastases diagnostic criteria|Diagnostic Criteria]] | [[Intracerebral metastases history and symptoms|History and Symptoms]] | [[Intracerebral metastases physical examination|Physical Examination]] | [[Intracerebral metastases laboratory findings|Laboratory Findings]] | [[Intracerebral metastases electrocardiogram|EKG]] | [[Intracerebral metastases chest x ray|Chest X ray]] | [[Intracerebral metastases CT|CT]] | [[Intracerebral metastases MRI|MRI]] | [[Intracerebral metastases echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Intracerebral metastases other imaging findings|Other Imaging Findings]] | [[Intracerebral metastases other diagnostic studies|Other Diagnostic Studies]]


==Clinical presentation and prognosis==
==Treatment==


These patients commonly present with headache, seizure, mental status changes, ataxia, nausea and vomiting and visual disturbances.  However, 10% of these patients may be asymptomatic.
[[Intracerebral metastases medical therapy|Medical Therapy]] | [[Intracerebral metastases surgery|Surgery]] | [[Intracerebral metastases primary prevention|Primary Prevention]] | [[Intracerebral metastases secondary prevention|Secondary Prevention]] | [[Intracerebral metastases cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Intracerebral metastases future or investigational therapies|Future or Investigational Therapies]]


Patients with brain mets have a mean survival of one month without treatment.  With treatment, survival improves, but it is still dismal.  The mean age of survival is still less than one year.
==Case Studies==
[[Intracerebral metastases case study one|Case #1]]


==References==
* Eichler AF, Loeffler JS. Multidisciplinary Management of Brain Metastases. The Oncologist 2007;12:884-898.
* Kumar V, Abbas AK, Fausto N. Robbins and Cotran Pathologic Basis of Disease. 7th ed. Philadelphia: Elsevier Saunders. 2005.
* Barnholtz-Sloan JS, Sloan AE, Davis FG, et al. Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the metropolitan Detroit cancer surveillance system. J of Clin Oncol 2004;22(14):2865-72.
==Source==
[http://www.radiopaedia.org Radiopaedia]


[[Category:Oncology]]
[[Category:Oncology]]

Revision as of 15:02, 12 September 2012

Intracerebral metastases

Intracerebral metastases Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Intracerebral Metastases from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor in Editor: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Intracerebral metastases from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria | History and Symptoms | Physical Examination | Laboratory Findings | EKG | Chest X ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1


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