What Is It?
A metastatic brain tumor is cancer that has spread (metastasized) from another part of the body to the brain. It is also called a secondary tumor, lesion or brain metastasis (plural: metastases). In contrast, a primary brain tumor starts in the brain, not in another part of the body.
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A tumor is an abnormal mass of tissue. It occurs when cells divide more than they should or don't die when they should.
Cancers that spread to the brain can originate in any part of the body. The original tumor is called the primary tumor. Metastatic brain tumors most commonly originate in the lung, breast, skin, colon, and kidney. A very aggressive form of skin cancer called melanoma often spreads to the brain.
Brain metastases occur when cancer cells break away from a primary tumor. They travel to the brain, usually through the bloodstream. These cancer cells may settle in the brain and continue growing. Sometimes only one secondary brain tumor occurs. But in many cases there are multiple lesions.
The brain is a complex organ enclosed in the skull. Among other things, it serves as the body's center of
- thought
- memory
- emotion
- speech
- vision
- hearing
- movement.
Symptoms
The signs and symptoms of secondary brain tumors depend on their size and location. This is because different parts of the brain control different functions.
As a tumor grows, it can press against or destroy normal brain tissue. It can also increase pressure inside the skull.
Signs and symptoms of brain metastases include
- headaches
- seizures
- visual changes, such as double vision
- lack of energy and/or sleepiness
- vomiting
- changes in mood, behavior, or personality
- weakness in parts of the body
- trouble speaking or hearing
- problems with memory or mental ability
- loss of balance or coordination.
These symptoms are not necessarily signs of brain metastases. But it is important to contact your doctor if you experience any of them.
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Some people with metastatic brain tumors don't show any symptoms. However, over time, the brain metastases will continue to grow, eventually causing symptoms.Diagnosis
The first step in diagnosis is usually a physical exam. Your doctor will check for general signs of disease. He or she will also ask about your health habits and past illnesses and treatments.
The following tests and procedures may be used to determine whether you have cancer that has spread to your brain.
Neurological and visual exams. These tests assess the your mental and physical abilities, including
- alertness
- muscle strength
- coordination
- reflexes
- response to pain
- eyesight
Tumor marker test. A sample of blood, urine, or tissue is taken. Levels of certain substances that may indicate the presence of cancer are measured.
Imaging tests:
- Computed tomography (CT) scan. An x-ray camera rotates around the body. It makes detailed, cross-sectional images of the brain.
- Magnetic resonance imaging (MRI). Radio waves and strong magnets produce detailed pictures of the brain. MRI is better than CT at finding metastatic brain tumors.
- Positron emission tomography (PET) scan. Radioactive glucose (sugar) is injected into the patient's vein. A rotating scanner highlights areas where cells are consuming the glucose. (Cancer cells use more glucose than normal cells.) PET scans may be used before or after treatment.
Lumbar puncture (spinal tap). Assuming it can be done safely, the doctor may want to remove cerebral spinal fluid from the lower back with a needle in some cases. The fluid is then checked for cancer cells.
Angiogram. A contrast dye is injected into the bloodstream and x-rays are taken. This allows the doctor to examine blood vessels and blood flow in the brain. It may identify blockages such as tumors. However, this procedure is less common than in the past because MRI can often provide the same information.
Biopsy. A small piece of tumor tissue is removed for examination. The tumor tissue may be tested for certain substances that provoke an immune response. It will also be analyzed for changes in the cells and their genetic material.
Biopsy can be done using a needle inserted through a hole in the skull. Or it may be done during surgery to remove a tumor.
Sometimes a biopsy can't be done safely because of the tumor location. In this case, the doctor uses imaging and other tests to make the diagnosis.
Sometimes the primary cancer is discovered after the patient is diagnosed with metastatic brain tumors. If brain lesions are the first sign of cancer, various imaging tests may be done to search for the primary tumor
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MRI Guided Brain Tumor Surgery is an advanced imaging treatment technique developed to enable neurosurgeons with intra-operative MRI to aid in the removal of complex and difficult-to-access brain tumors during surgery. The technique involves use of a powerful computer system that precisely helps neurosurgeon locate a lesion, plan each step of the procedure on computer screen and find out the ideal access to the tumor before performing the operation.The technique is particularly helpful in treating a tumor that has difficult accessibility such as it is located deep inside the brain. During the procedure, the instrument movement is tracked very precisely by the computer providing surgeon with total control inside the brain with the help of real-time imaging. The technique also helps the surgeon to check if the tumor has been removed.
The Brain Suite has two main parts. There is a high-intensity MRI scanner integrated with an image-guided surgical system. The MRI scanner has a wide-bore opening allowing a patient to lie on his or her side. Previously, tumors that could only be accessed from the side of the skull were not easy to scan. This special MRI system lets doctors repeat scans during the operation to get more accurate information on the location, shape and size of the tumor. This minimizes problems associated with brain tumors shifting during excision.
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