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Metastatic Disease - Breast Cancer - Case 4

A 43 year-old woman with breast cancer presented with headaches, difficulty expressing her words, and focal right sided seizures.

Show the Vasogenic Edema                              Show the Tumor                            Show the Gadolinium Enhancement

Metastatic Brain Tumor (Breast Cancer): (Left) T2-weighted axial MRI; (Middle) T1-weighted axial MRI; (Right) T1-weighted with gadolinium axial MRI. Note the well-defined nodular mass in the left frontal lobe, consistent with a metastatic lesion. In this case of a solitary metastasis, neurosurgical evacuation was performed.

Metastatic disease from primary tumors elsewhere in the body account for approximately 50% of all brain tumors. Metastases to the brain are nearly always via the blood stream. They are typically found at the junctions between the gray and white matter, which are highly vascular. Metastatic lesions commonly present with focal or focal to generalized seizures or slowly progressive neurological deficits. When the lesions become very large, signs and symptoms of increased intracranial pressure develop (i.e., headache, lethargy, nausea and vomiting). The most common primary tumors that metastasize to the brain are lung and breast. Other tumors may also spread to the brain, including melanoma, lymphoma, GI, and GU cancers. In some cases, it is the metastatic lesion in the brain, and not the primary tumor, that brings the patient to medical attention.


Revised 11/29/06.
Copyrighted 2006. David C Preston