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| Metastatic Carcinoma | ||
| Etiology •Tumor emboli which hang up in small blood vessels (usually arterioles) and grow through the vascular wall into the parenchyma or more rarely the meninges. | ||
| Pathogenesis •After the metastasis has grown into the parenchyma, vascular growth factors cause more blood vessels to grow in to nourish the tumor and produce the surrounding vasogenic edema., | ||
| Epidemiology •Approximately 24% of patients coming to autopsy with a primary tumor elsewhere will have brain metastases. •Occult neoplasms can also cause brain metastases. •The most common sources for metastases are lung, breast, colon, melanoma and renal in order of prevalence. •Approximately 20% of intracranial and intraspinal tumors are metastatic. | ||
| General Gross Description •Cerebral metastases appear as one or more rounded circumscribed whitish often necrotic lesion anywhere in the CNS but often at the grey-white junction where arteries sharply decline in size. •Examples: | ||
| General Microscopic Description •Microscopically the cerebral metastasis looks like the primary tumor although it may be more or less differentiated. •Often there is a border of viable tumor with a necrotic sometimes hemorrhagic center. •There is usually surrounding spongy change due to edema along with reactive astrocytes. •Examples: | ||
| Clinical Correlation •The symptoms of the metastatic tumor depend on where it lies. In the motor strip it can produce hemipareses or Jacksonian seizures (seizures starting with shaking of the affected extremity followed often but not always by a generalized seizure. | ||
| References • Poirer J et.al. Manual of basic neuropathology. Philadelphia: Saunders, 1990, pp.48-50. • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1349-1351. Please be patient during transfer. Medline will open in a new window. To return, close the Medline Window Metastatic Carcinoma
| Synopsis by: Dr ML Grunnet (TX2000M80106)[589]
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