A metastatic, or secondary, brain tumor is one that begins as cancer in another part of the body. Some of the cancer cells may be carried to the brain by the blood or lymphatic fluid, or may spread from adjacent tissue. The site where the cancerous cells originated is referred to as the primary cancer. Metastatic brain tumors are often referred to as lesions or brain metastases. Metastatic brain tumors are the most common brain tumors. There has been an increase in metastatic lesions as people are surviving primary cancers for longer periods of time.
DiagnosisThe diagnosis of these tumors is typically made by a brain MRI with and without contrast which will show the exact location and number of metastatic tumors. A CT scan without and with contrast will reliably show the number and location of metastatic brain tumors.
The original (primary) tumor may already be known, or it may be discovered after an examination of tumor tissues from the brain indicates that it is a metastatic type of tumor.
- A CT scan or MRI of the brain can confirm the diagnosis of brain tumor and identify the location of the tumor. MRI is usually better for finding tumors in the brain.
- Cerebral angiography is occasionally performed. It may show a space-occupying mass, which may or may not be highly vascular (filled with blood vessels).
- A chest x-ray, mammogram, CT scans of the chest, abdomen, and pelvis, and other tests are performed to look for the original site of the tumor.
- An EEG may reveal abnormalities.
- An examination of tissue removed from the tumor during surgery or CT scan-guided biopsy is used to confirm the exact type of tumor. If the primary tumor can be located outside of the brain, the primary tumor is usually biopsied rather than the brain tumor.
- A lumbar puncture (spinal tap) is sometimes also performed to test the cerebral spinal fluid.
- The primary cancer is usually in the lung, breast, colon, kidney, or skin (melanoma), but can originate in any part of the body
- Most are located in the cerebrum, but can also develop in the cerebellum or brain stem
- More than half of people with metastatic tumors have multiple lesions (tumors)
- Common among middle-aged and elderly men and women
- Behavioral and cognitive changes
- Lack of coordination
TreatmentSurgery and radiosurgery are the standard treatments if lesions are limited in number and accessible. Both of these treatments may be followed by whole brain radiation therapy (WBRT). In cases of multiple lesions, WBRT alone may be given. Chemotherapy specific to the brain-located metastatic tumor may be used.
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