Abstract
Brain metastasis are the most common neoplastic lesions of the nervous system. Many cancer patients are diagnosed on the basis of a first clinical presentation of cancer on the basis of a single or multiple brain lesions. Brain metastases are manifestations of primary disease progression and often determine a poor prognosis. Not all patients with a brain metastases undergo surgery: many are submitted to alternative or palliative treatments. Management of patients with brain metastases is still controversial, and many studies have been developed to determine which is the best therapy. Furthermore, management of patients operated for a brain metastasis is often difficult. Chemotherapy, stereotactic radiosurgery, panencephalic radiation therapy, and surgery, in combination or alone, are the means most commonly used. We report our experience in the management of a ten-year series of surgical brain metastasis and discuss our results in the preoperative and postoperative management of this complex condition.
Highlights
Brain metastases represent the most frequent type of intracranial tumors, being a common complication of cancer
Brain metastases are surgically treated according to the following criteria: (i) necessity of definitive histological diagnosis, (ii) relatively good prognosis, (iii) absence of extracranial metastatic localizations, (iv) life-threatening intracranial hypertension
We report a ten-year series of patients affected by brain metastases who were submitted to surgery
Summary
Brain metastases represent the most frequent type of intracranial tumors, being a common complication of cancer. The most common sources of brain metastases are lung, breast, or melanoma, and in as many as 15% of patients, primitive localization remains uncertain [1]. The frequency of brain metastases has increased over time, probably as a result of advances in neuroimaging procedures and improvements in the treatment of primary and systemic cancer disease. Head CT studies and MRIs offer high quality imaging, there are not characteristic features which enable us to distinguish brain metastases from primary malignant brain tumors or nonneoplastic conditions [1, 2]. Most patients who develop brain metastases have a relatively short prognosis even if initial treatment is often successful. Survival is determined by the progression of systemic disease or by ineffective control of neurological disease [3, 4]
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