Radiologic clues to differentiate metastases from other brain pathologies with histopathological correlation

Abstract

Introduction:The dissemination of tumour cells to the brain parenchyma does solely occur via the blood stream, as the brain lacks lymphatic vessels. Therefore, tumour cells have to manage survival and adapt to the changed microenvironment within the bloodstream. Several preclinical studies indicate that tumour cells might aggregate with platelets and leucocytes in order to survive. Methodology: This study was performed at the Department of Radio-diagnosis, and the patients selected for the study were referred from Neurosurgery/Neurology OPD or Emergency department at our hospital, who were clinically suspected to have a space occupying lesion or having history suggestive of metastases. The patients presented with symptoms like headache, motor weakness, diminished vision, double vision, seizure. All patients were seen by appointment, except for the emergency cases. Relevant history of illness and significant clinical findings of all patients were recorded. Results: Out of 50 cases adenocarcinoma (66%) was the most common histopathology metastasized to the brain followed by squamous cell type (16%), Melanoma (6%), GBM (2%), Oligodendroglioma (2%), liposarcoma (2%) and choriocarcinoma (2%). Conclusion: In our study most common primary site of metastases was from lung (60%), site of origin of primary was not identified in the 10% cases, third common primary was from breast (6%), kidney (6%), Melanoma(6%) followed by brain (2%), thyroid(2%), Cervix (1%) and uterus(1%).