Neuro Diseases: Metastatic Brain Cancer

Introduction

Metastatic brain cancer (secondary brain tumor) is not uncommon. Brain is one of the preferred sites of spread to many types or cancers in the body.

Tumor spread to the brain is common in late middle-aged and older adults.

Tumors that usually spread to the brain

• Lung cancer
• Breast cancer
• Gastrointetinal cancer
• Genitourenary cancer
• Skin cancer etc.

Melanoma, a type of skin cancer has one of the highest tendencies to spread to the brain although its incidence is low so only a small percentage of secondary brain tumors are due to melanoma.

Certain tumors like prostate extremely rarely go to the brain tissue. It may spread to the spine bone and sometimes skull bone but very unusual to spread to the brain tissue itself.

The tumors can spread to the brain in 2 ways; either directly to the brain tissue or to the meninges (brain coverings). The second condition is called as carcinomatous meningitis.

How does the patient present?

There are two types of manifestations; related with the primary tumor and related with spreading to the brain.

The manifestations related to the primary tumor depend on from where the tumor originates. So a lung cancer may present with cough, coughing blood; breast cancer with a mass in the breast; gastrointestinal cancer with bleeding per rectum, diarrhea or constipation; genitourinary tumor with blood in the urine etc.

The manifestations related to the Metastatic Brain Cancer will depend upon what area of the brain is involved, whether meninges are involved too etc. In general the manifestations include; seizures, focal weakness or numbness, headache, vomiting, facial droop, double vision etc.

Diagnosis

The primary tumor may be diagnosed with a CT or MRI of the concerned organ. A CT or MRI of the brain too needed. A CSF (cerebrospinal fluid) analysis is needed if carcinomatous meningitis is suspected. A biopsy of the primary or secondary brain tumor may be necessary to get a definitive diagnosis.

Treatment

Depending upon the type of tumor, its spread and staging the different treatment options include surgery, chemotherapy, radiotherapy etc.

If seizures are present anti seizure medications are used. If lot of brain swelling is present a course of steroid may be used.

Primacy tumor is also treated appropriately.

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