| Metastatic Carcinoma
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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.
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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.,
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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.
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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.
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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.
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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.
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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.
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| Metastatic Carcinoma
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| Synopsis by: Dr ML Grunnet (TX2000M80106)[589]
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