Metastatic Brain Tumors

  • Overall the most common brain tumors are metastatic brain tumors which arise from a primary tumor elsewhere in the body.
  • The distribution of metastatic tumor types in the brain reflects the distribution of systemic tumors in the general population
  • Therefore, most brain metastases arise from lung cancer, breast cancer, or  melanoma, which represent the three most common sites of primary tumors.
  • The number and location of metastases guides the determination of the proper treatment approach, especially the decision for surgical resection.
  • A major predictor of survival is the number of cranial lesions that occur in patients who present with metastatic brain disease.

Metastatic Tumor Case Presentation:

  • 65-year-old right handed lady with the history of metastatic ovarian cancer who presented with dysarthria and difficulty with bringing the right word out (anomia).
  • Her condition rapidly evolved  into inablility in moving her right arm and leg, and speak (aphasia, and right hemiparesis) and she was brought to the emergency room.
  • Although patient could understand spoken language, she was unable to express herself (expressive aphasia).
  • She underwent  image guided frameless stereotactic craniotomy with intraoperative motor cortex mapping

Stereotactic map of the brain was created with 1 mm accuracy around the lesion.  The tumor was volumetrically mapped and removed after identifying and avoiding injury to motor cortex.

Postoperatively her language function normalized.  Further, her Right sided weakness immediately improved and she was able to walk and use her right arm at a normal level.