Brain metastases

Last edit by Alaric Steinmetz on

Synonyms: Brain metastasis

Brain metastases are space-occupying lesions in the brain that originate from a primary tumor located outside the brain. Depending on their number, size, and clinical symptoms, surgical removal may be indicated. In principle, brain metastases can occur anywhere in the brain.

Epidemiology

In adults, brain metastases are the most common tumors in the brain and occur annually in 10–15 per 100 000 persons; in 30–50 % of cases, they are solitary metastases[^2].

Primary tumors

Lung carcinomas, renal cell carcinomas, and colorectal carcinomas account for approximately 80% of brain metastases in men, whereas in women, breast carcinomas, lung carcinomas, colorectal carcinomas, and melanomas are responsible for 80% of metastases[^3].

The risk of developing a brain metastasis varies depending on the primary tumor[^1]:

Primary tumor

Estimated cumulative incidence after 5 years

Lung carcinoma

16,3 %

Renal cell carcinoma

9,8 %

Melanoma

7,4 %

Breast carcinoma

5 %

Colorectal carcinoma

1,2 %

Imaging

The gold standard for imaging brain metastases is MRI imaging. In brain metastases involving the bone, additional CT imaging may be helpful.

Brain metastases on MRI
Axial T1-weighted contrast-enhanced MRI image showing two right-sided brain metastases.
CT of an osseous brain metastasis
Noncontrast CT of an osseously infiltrating brain metastasis.

Radiosensitivity

Depending on the primary tumor, brain metastases show varying degrees of response to radiation therapy. The following table shows the radiosensitivity of various brain metastases to Whole-brain radiation therapy[^4] [^5]:

Radiosensitivity

Tumor

Radiosensitive

  • Small-cell lung carcinoma

  • Germ cell tumor

  • Lymphoma

  • Multiple myeloma

  • Leukemia

Moderately sensitive

  • Breast carcinoma

Moderately resistant

  • Colon

  • NSCLC

Highly resistant

  • Thyroid

  • Renal cell carcinoma

  • Malignant melanoma

  • Sarcoma

  • Adenocarcinoma

Article information

Article created by
Last edited:
on
Revision history
Show revision history (3)

3 edits by 1 author

Edit · Alaric Steinmetz · (+574 −60)
  • Text added: “Epidemiology”
  • Text added: “In adults, brain metastases are the most common tumors in the brain and occur annually in 10–15 per 100 000 persons; in 30–50 % of cases, they are solitary metastases[^2].”
  • Text added: “Primary tumors”
  • Text added: “Lung carcinomas, renal cell carcinomas, and colorectal carcinomas account for approximately 80% of brain metastases in men, whereas in women, breast carcinomas, lung carcinomas, colorectal carcinomas, and melanomas are responsible for 80% of metastases[^3].”
  • Text added: “Imaging”
  • Text added: “The gold standard for imaging brain metastases is MRI imaging . In brain metastases involving the bone, additional CT imaging may be helpful.”
  • Text added: “Radiosensitivity”
  • Text added: “Depending on the primary tumor, brain metastases show varying degrees of response to radiation therapy. The following table shows the radiosensitivity of various brain metastases to Whole-brain radiation therapy [^4] [^5]:”
  • Text removed: “## Epidemiology {#epidemiologie} Brain metastases are the most common tumors in the brain in adults and occur annually in 10–15 per 100 000 people; in 30–50 % of cases, they are solitary metastases[^2].”
  • Text removed: “## Primary Tumors {#primaertumore} Lung carcinomas, renal carcinomas, and colon carcinomas account for approximately 80% of brain metastases in men, whereas in women, breast carcinomas, lung carcinomas, colon carcinomas, and melanomas are responsible for 80% of metastases[^3].”
  • Text removed: “| Primary tumor | Estimated cumulative incidence after 5 years | | ------------|------------------------------------| | Lung carcinoma | 16,3 % | | Renal carcinoma | 9,8 % | | Melanoma | 7,4 % | | Breast carcinoma | 5 % | | Colorectal carcinoma | 1,2 % |”
  • Text removed: “## Imaging {#bildgebung} The gold standard for imaging brain metastases is [MRI imaging](\/lexikon\/magnetresonanztomographie-mrt). In brain metastases involving the bone, additional CT imaging may be helpful.”
  • Text removed: “## Radiosensitivity {#strahlensensitivitaet} Depending on the primary tumor, brain metastases show varying degrees of response to radiation. The following table shows the radiosensitivity of various brain metastases to [whole-brain radiotherapy](\/lexikon\/ganzhirnbestrahlung-wbrt)[^4] [^5]:”
  • Text removed: “| Radiosensitivity | Tumor | | ----------------- | ------ | | Radiosensitive | Small-cell lung carcinoma <br \/> Germ cell tumor <br \/> Lymphoma <br \/> Multiple myeloma <br \/> Leukemia | | Moderately sensitive | Breast | | Moderately resistant | Colon <br \/> NSCLC <br \/> | | Highly resistant | Thyroid <br \/> Renal cell carcinoma <br \/> Malignant melanoma <br \/> Sarcoma <br \/> Adenocarcinoma |”
  • Text removed: “**References**”
  • Text removed: “[^1]: Schouten, Leo J., et al. "Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma." Cancer 94.10 (2002): 2698-2705. [^2]: [Delattre J, Krol G, Thaler H, Posner J. Distribution of Brain Metastases. Archives of Neurology. 1988;45(7):741-744.](https:\/\/doi.org\/10.1001\/archneur.1988.00520310047016) [^3]: Neurosurgery Case Review: Questions and Answers. Remi Nader, Abdulrahman J Sabbagh. 2020 Thieme Verlage. ISBN 9781626231986 [^4]: [Patchell RA, Tibbs PA, Walsh JW, et al. A Randomized Trial of Surgery in the Treatment of Single Metastases to the Brain. N Engl J Med. 1990;322:494-500.](https:\/\/doi.org\/10.1056\/NEJM199002223220802) [^5]: Handbook of Neurosurgery. Greenberg M, ed. 9th Edition. New York: Thieme; 2019.”
  • Text changed: “Brain metastases are defined as space-occupying lesions in the brain that originate from a primary tumor located outside the brain. Depending on their number, size, and clinical symptoms, surgical removal may be indicated. In principle, brain metastases can occur anywhere in the brain.”“Brain metastases are space-occupying lesions in the brain that originate from a primary tumor located outside the brain. Depending on their number, size, and clinical symptoms, surgical removal may be indicated. In principle, brain metastases can occur anywhere in the brain.”
  • Text changed: “Depending on the primary tumor, the risk of developing a brain metastasis varies[^1]:”“The risk of developing a brain metastasis varies depending on the primary tumor[^1]:”
  • Citation added: “Schouten, Leo J., et al. "Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma." Cancer 94.10 (2002): 2698-2705.”
  • Citation added: “Delattre J, Krol G, Thaler H, Posner J. Distribution of Brain Metastases. Archives of Neurology. 1988;45(7):741-744”
  • Citation added: “Patchell RA, Tibbs PA, Walsh JW, et al. A Randomized Trial of Surgery in the Treatment of Single Metastases to the Brain. N Engl J Med. 1990;322:494-500.”
  • Citation removed: “Schouten, Leo J., et al. Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma. Cancer 94.10 (2002) 2698-2705.”
  • Citation removed: “Delattre J, Krol G, Thaler H, Posner J. Distribution of Brain Metastases. Archives of Neurology. 1988;45(7):741-744.”
  • Citation removed: “Neurosurgery Case Review: Questions and Answers. Remi Nader, Abdulrahman J Sabbagh. 2020 Thieme Verlage. ISBN 9781626231986”
  • Citation removed: “Handbook of Neurosurgery. Greenberg M, ed. 9th Edition. New York: Thieme; 2019.”
  • Image removed: zystische_hirnmetastase_mri.png
Edit · Alaric Steinmetz ·

No content change recorded

Article created on · Alaric Steinmetz

Author list:
Newsletter