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01-05-2019 | Metastasis | Clinical Study

Propensity for different vascular distributions and cerebral edema of intraparenchymal brain metastases from different primary cancers

Authors: David Mampre, Jeff Ehresman, Keila Alvarado-Estrada, Olindi Wijesekera, Rachel Sarabia-Estrada, Alfredo Quinones-Hinojosa, Kaisorn L. Chaichana

Published in: Journal of Neuro-Oncology | Issue 1/2019

Abstract

Purpose

This study seeks to ascertain whether different primary tumor types have a propensity for brain metastases (BMs) in different cerebral vascular territories and cerebral edema.

Methods

Consecutive adult patients who underwent surgical resection of a BM at a tertiary care institution between 2001 and 2011 were retrospectively reviewed. Only patients with the most common primary cancers (lung, breast, skin-melanoma, colon, and kidney) were included. Preoperative MRIs were reviewed to classify all tumors by cerebral vascular territory (anterior cerebral artery-ACA, lenticulostriate, middle cerebral artery-MCA, posterior cerebral artery-PCA, posterior fossa, and watershed), and T2-weighted FLAIR widths were measured. Chi square analyses were performed to determine differences in cerebral vascular distribution by primary tumor type, and one-way ANOVA analyses were performed to determine FLAIR signal differences.

Results

669 tumors from 388 patients were classified from lung (n = 316 BMs), breast (n = 144), melanoma (n = 119), renal (n = 47), and colon (n = 43). BMs from breast cancer were less likely to be located in PCA territory (n = 18 [13%]; χ² = 6.10, p = 0.01). BMs from melanoma were less likely to be located in cerebellar territory (n = 11 [9%]; χ² = 14.1, p < 0.001), and more likely to be located in lateral (n = 5 [4%]; χ² = 4.56, p = 0.03) and medial lenticulostriate territories (n = 2 [2%]; χ² = 6.93, p = 0.009). BMs from breast and melanoma had shorter T2-FLAIR widths, with an average [IQR] of 47.2 [19.6–69.2] mm (p = 0.01) and 41.2 [14.4–62.7] mm (p = 0.002) respectively. Conversely, BMs from renal cancer had longer T2-FLAIR widths (64.2 [43.6–80.8] mm, p = 0.002).

Conclusions

These findings suggest that different primary tumor types could have propensities for different cerebral vascular territories and cerebral edema.

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Title: Propensity for different vascular distributions and cerebral edema of intraparenchymal brain metastases from different primary cancers
Authors: David Mampre
Jeff Ehresman
Keila Alvarado-Estrada
Olindi Wijesekera
Rachel Sarabia-Estrada
Alfredo Quinones-Hinojosa
Kaisorn L. Chaichana
Publication date: 01-05-2019
Publisher: Springer US
Keywords: Metastasis
Melanoma
Melanoma
Breast Cancer
Brain Tumor
Breast Cancer
Cerebral Edema
Renal Cancer
Published in: Journal of Neuro-Oncology / Issue 1/2019
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-019-03142-x

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Propensity for different vascular distributions and cerebral edema of intraparenchymal brain metastases from different primary cancers

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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