Brain metastases

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By Edward J Dropcho MD

Metastatic brain tumors arising from systemic cancer affect more than 200,000 people in the United States each year. Brain metastases have a potentially devastating effect on quality of life and patient survival. Recent developments in treatment of patients with brain metastases include stereotactic radiosurgery following surgical resection, molecularly targeted agents, and immunotherapy. Dr. Edward Dropcho of Indiana University Medical Center summarizes the clinical features of brain metastases and provides an updated summary and critique of currently available treatments.

Key points

  • Metastasis to the brain parenchyma is the single most frequent neurologic complication of several common neoplasms, including lung cancer, breast cancer, and melanoma.
  • Brain metastases often have a devastating impact on patients' quality of life and are fatal if not controlled.
  • Treatment options for patients with brain metastases include surgical resection, whole-brain radiation therapy, stereotactic radiosurgery, and in some cases chemotherapy or molecularly targeted therapy.
  • The management of patients with brain metastases needs to be individualized based on the primary tumor type, number, size, and location of brain metastases, status of the systemic tumor, patients' neurologic and overall performance status, and anticipated duration of survival.

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited