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

2 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

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