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

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

Research output: Contribution to journalArticle

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%]; χ 2 = 6.10, p = 0.01). BMs from melanoma were less likely to be located in cerebellar territory (n = 11 [9%]; χ 2 = 14.1, p < 0.001), and more likely to be located in lateral (n = 5 [4%]; χ 2 = 4.56, p = 0.03) and medial lenticulostriate territories (n = 2 [2%]; χ 2 = 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.

Original languageEnglish (US)
JournalJournal of neuro-oncology
DOIs
StatePublished - Jan 1 2019

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Brain Edema
Blood Vessels
Neoplasm Metastasis
Brain
Melanoma
Neoplasms
Passive Cutaneous Anaphylaxis
Colon
Breast
Breast Neoplasms
Posterior Cerebral Artery
Kidney
Anterior Cerebral Artery
Kidney Neoplasms
Middle Cerebral Artery
Tertiary Healthcare
Lung Neoplasms
Analysis of Variance
Lung
Skin

Keywords

  • Breast
  • Lung
  • Melanoma
  • Metastatic brain tumors
  • Renal
  • Vascular distribution

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Cite this

Propensity for different vascular distributions and cerebral edema of intraparenchymal brain metastases from different primary cancers. / Mampre, David; Ehresman, Jeff; Alvarado-Estrada, Keila; Wijesekera, Olindi; Sarabia Estrada, Rachel; Quinones-Hinojosa, Alfredo; Chaichana, Kaisorn L.

In: Journal of neuro-oncology, 01.01.2019.

Research output: Contribution to journalArticle

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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{\%}]; χ 2 = 6.10, p = 0.01). BMs from melanoma were less likely to be located in cerebellar territory (n = 11 [9{\%}]; χ 2 = 14.1, p < 0.001), and more likely to be located in lateral (n = 5 [4{\%}]; χ 2 = 4.56, p = 0.03) and medial lenticulostriate territories (n = 2 [2{\%}]; χ 2 = 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.",
keywords = "Breast, Lung, Melanoma, Metastatic brain tumors, Renal, Vascular distribution",
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T1 - Propensity for different vascular distributions and cerebral edema of intraparenchymal brain metastases from different primary cancers

AU - Mampre, David

AU - Ehresman, Jeff

AU - Alvarado-Estrada, Keila

AU - Wijesekera, Olindi

AU - Sarabia Estrada, Rachel

AU - Quinones-Hinojosa, Alfredo

AU - Chaichana, Kaisorn L.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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%]; χ 2 = 6.10, p = 0.01). BMs from melanoma were less likely to be located in cerebellar territory (n = 11 [9%]; χ 2 = 14.1, p < 0.001), and more likely to be located in lateral (n = 5 [4%]; χ 2 = 4.56, p = 0.03) and medial lenticulostriate territories (n = 2 [2%]; χ 2 = 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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KW - Breast

KW - Lung

KW - Melanoma

KW - Metastatic brain tumors

KW - Renal

KW - Vascular distribution

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