Intracerebral metastases are different from the cancer that starts in the brain (called primary brain cancer). Primary brain tumors occur much less often than intracerebral metastases. It is estimated that 20–40% of intracerebral tumors are metastatic. Cancers that start in the brain usually remain in one place (solitary mass). If there is more than one tumor in the brain, they are most probably intracerebral metastases. The ability of cancer cells to sever their link to the primary tumor site and commence the metastatic process, once specific functions have been acquired by an appropriate subset of cancer cells. The multistep cascade can be grouped into two stages: migration (intravasation, dissemination, and extravasation) and colonization. Genes involved in the pathogenesis of intracerebral metastases include RHoC, LOX, VEGF, and CSF1. On gross pathology, intracerebral metastases are characterized by single-to-multiple masses typically found in the watershed areas of the brain, that are sharply demarcated from the surrounding parenchyma and usually have a zone of peritumoral edema that is out of proportion with the tumor size. On microscopic histopathological analysis, intracerebral metastases are characterized by tubule formation, well-circumscribed and sharply demarcated from surrounding tissues, with mitoses and nuclear atypia. Intracerebral metastases are demonstrated by positivity to tumor markers such as pankeratin, TTF-1, CK7, and CK20.
Intracerebral metastases pathophysiology
Intracerebral metastases risk factors
Intracerebral metastases causes
Brain tumor differential diagnosis
Glioma differential diagnosis
Intracerebral metastases epidemiology and demographics
Meningioma differential diagnosis
Meningioma risk factors