Last Updated on Nov 27, 2018

What is Brain Metastasis?

In Siddhartha Mukherjee’s “The Emperor of All Maladies: A Biography of Cancer”, metastasis is defined as “the spread of tumors from one site to another, causing outcroppings of the disease in distant sites, such as the brain, the bones, or the lungs”. Brain cancer (tumors that develop within the brain) accounts for only 2 percent of all cancers but brain metastases (i.e. primary tumors that spread to the brain from distant sites) are more common with an estimated 10-20 percent of cancer patients. The frequency of brain metastases in different regions of the brain, are: cerebellum (15%), cerebrum (80%), and brainstem (5%).

What are the Causes of Brain Metastasis?

Any primary tumor that can spread to the brain is termed as brain metastasis.

Primary tumors of the lung, breast, kidney, colon, genitourinary tract, gastrointestinal tract, and the skin (melanoma) metastasize to the brain. Melanoma has the highest likelihood (nearly 50%) to metastasize to the brain.

Most common sources of brain metastases: The most common sources of brain metastases are lung, melanoma, and breast cancers. The tumor cells travel to the brain through the venous system (Batson’s plexus) that passes out from the skull and the spinal column or through the extensions of the sinus or the arteries.

References:

  1. Mukherjee S. The Emperor of all Maladies: A Biography of Cancer. London: Fourth Estate, 2011.
  2. Vachani C. All about brain metastases - OncoLink - (https://www.oncolink.org/cancers/brain-tumors/brain-metastasis/all-about-brain-metastases)
  3. Gould J. Breaking down the epidemiology of brain cancer. Nature. 2018; 561: S40-S41. - (https://www.nature.com/articles/d41586-018-06704-7)
  4. Eichler AF, Loeffler JS. Multidisciplinary management of brain metastases. Oncologist. 2007;12(7): 884-98. - (http://theoncologist.alphamedpress.org/content/12/7/884.full)
  5. Hardesty DA, Nakaji P. The current and future treatment of brain metastases. Front Surg. 2016; 3: 30. (DOI:10.3389/fsurg.2016.00030). PMID: 27252942. - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4879329/)
  6. Newton HB. Neurologic complications of systemic cancer. Am Fam Physician. 1999; 59(4): 878-86. - (https://www.aafp.org/afp/1999/0215/p878.html)
  7. Nivolumab and ipilimumab effective against melanoma that has spread to the brain - National Cancer Institute, National Institutes of Health (NIH), USA - (https://www.cancer.gov/news-events/cancer-currents-blog/2018/melanoma-brain-metastases-nivolumab-ipilimumab)
  8. Shipp S. Structure and function of the cerebral cortex. Curr Biol. 2007; 17(12): PR443-449. - (https://www.cell.com/current-biology/fulltext/S0960-9822(07)01148-7#secsection0015)

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