Metastatic Brain Tumors

The term metastatic tumor refers to tumors that have spread to a distant location, away from the primary tumor. Although some primary brain tumors can spread either within the nervous system or outside the nervous system, we will focus here on tumors that enter the nervous system from the rest of the body.

The most common tumors that spread to the nervous system are lung cancer, breast cancer, renal cell (kidney) cancer, colon cancer and melanoma (skin cancer). This is only a partial list, but it accounts for the majority of brain metastases. The tumors can be single or multiple. The incidence of metastatic brain tumors is high and appears to be increasing. This increase might be due to increased survival of cancer patients in general, increased ability to discover brain tumors with CT and MRI scans and a number of other factors relating to cancer treatment. For more info on metastatic tumors click here.

Symptoms

The symptoms of metastatic brain tumors depend on their location, number, rate of growth and amount of swelling (edema). Increased pressure inside the head is common with headache, nausea and vomiting. Stroke-like symptoms can occur with strength or speech problems. Seizures may also occur.

Diagnosis

As always, a careful history and physical examination are the first steps in diagnosis. A CT scan or better yet, an MRI scan performed without and with intravenous contrast enhancement is the next step. Frequently, a diagnosis of cancer will already have been made. If, however, there is no prior diagnosis, the patient will (if metastatic disease is suspected) need to undergo a "primary workup", usually under the direction of an oncologist or the patients' primary doctor.

Treatment

The treatment of metastatic brain tumors is different for each patient. Steroids are almost always started to relieve some of the associated brain swelling (edema). Open brain surgery followed by radiation therapy and for some patients chemotherapy is often recommended. More recently, patients are being treated with stereotactic radiosurgery as the primary method of treatment. This is often the case in patients with multiple tumors.

To learn more about metastatic tumors, click here.

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