Abstract
PurposePrior reports on the location and sizes of brain metastases almost entirely focus on patients with primary breast and pulmonary cancer. This is the first study comparing multiple other types of cancer that metastasize to the brain.MethodsThis monocentric retrospective study includes 369 untreated patients with 3313 intraaxial brain metastases. Following semi-manual segmentation of metastases on post-contrast T1WI, cumulative spatial probability distribution maps of brain metastases were created for the whole group and for all primary tumors. Furthermore, mixed effects logistic regression model analysis was performed to determine if the primary tumor, patient age, and patient sex influence lesion location.ResultsThe cerebellum as location of brain metastases was proportionally overrepresented. Breast and pulmonary cancer caused higher number of brain metastases to what would normally be expected. Multivariate analyses revealed a significant accumulation of brain metastases from skin cancer in a frontal and from breast and gastrointestinal cancer in a cerebellar location.ConclusionDistribution of brain metastases is very heterogeneous for the distinct primaries, possibly reflecting the diversity of mechanisms involved in brain metastases formation. In daily clinical practice distribution patters may be beneficial to predict the primary cancer site, if unknown.
Highlights
Brain metastases (BM) as secondary brain neoplasms are the most common type of brain tumors in adults [1]
Other systemic metastases than BM were present in 324/369 (87.8%) patients. 42/369 (10.3%) patients developed a carcinomatous meningitis (including 14 (33.3%) patients with pulmonary, 12 (28.6%) with breast, 8 (19.0%) with genitourinary, 4 (9.5%) with skin, 2 (4.8%) with sarcoma, 1 (2.4%) with cancer of unknown primary, and 1 (2.4%) patient with gastrointestinal cancer)
We aimed to evaluate BM distribution originating from various tumor entities
Summary
Brain metastases (BM) as secondary brain neoplasms are the most common type of brain tumors in adults [1]. Incidence was shown to be 14/100.000 per year, which markedly exceeds the frequency of primary brain tumors (7.25) [2, 3]. BM occur in 8.5–9.6% of cancer patients following hematogenous spread. The most common primary tumors are pulmonary (39–56%), breast (13–30%), skin (8–11%), gastrointestinal (6–9%), and renal cancer (2–6%) [4,5,6,7,8,9,10,11,12]. Prognosis of patients with metastatic disease of the brain was shown to be very poor with an overall survival (OS) of one to 2 months if untreated [13]. Certain forms of non-small cell lung cancer (NSCLC) and human epidermal growth factor receptor 2-positive breast cancer were shown to have a better prognosis [14,15,16].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
