Brain Metastases

Hirnmetastasen

Hirnmetastasen sind Absiedlungen, die von Krebserkrankungen anderer Organe stammen. Dabei wandern vom Primärtumor losgelöste Tumorzellen meist über die Blutbahn ins Gehirn und bilden dort solide Metastasen. Es wird zwischen solitären, singulären und multiplen Hirnmetastasen unterschieden.

solitär: einzige Absiedlung, bei fehlenden Absiedlungen im gesamten Körper

singulär: einzige Absiedlung im Gehirn, weitere in anderen Organen

multiple: gleichzeitig mehrere Tumorherde im zentralen Nervensystem

Aktuelles aus dem Hirnmetastasen Forum

Aktuelle Beiträge zum Thema Hirnmetastasen [ Frage stellen ]	Antw.
Was kommt auf mich zu? (CUP-Syndrom & 2 Hirnmetastasen)	0
Hilfe bei Meningeosis Carcinomatosa	1
Haarausfall nach stereotaktischer Bestrahlung?	4
Hirnmetastasen Bestrahlung?	2
Gibt es Physiotherapie nach einer OP?	3

Distribution of Brain Metastases in Metastases from

40-60% bronchial carcinoma (lung cancer)
15-20% mamma carcinoma (breast cancer)
10-15% malignant melanoma (pigmented skin cancer)
10-20% primary tumour unknown, 5% remain unknown
5% gastrointestinal carcinoma (digestive tract)
5% renal cell carcinoma

Development of Brain Metastases from

45% of malignant melanoma (pigmented skin cancer)
45% of small-cell bronchial carcinoma (lung cancer)
30% of non-small-cell bronchial carcinoma (lung cancer)
20% of mamma carcinoma (breast cancer)
20% of renal cell carcinoma
8% of gastrointestinal carcinoma (digestive tract)
6% of tumours of urinary tract/ bladder
2% of prostate carcinoma

Symptoms of Brain Metastases

depending on localisation
50% headache
50% neurological deficits
30% organic brain syndrome
15-20% epileptic seizure
further signs of intracranial pressure (nausea, emesis, fatigue)

Diagnosing Brain Metastases

with CT or MRI with contrast agent
if primary tumour is unknown, biopsy to determine tissue
if necessary liquor examination
annular contrast agent enhancement
edema
often hemorrhages
main localisation: mainly in cerebrum, less often in cerebellum and brain stem

Therapy of Brain Metastases

depending on quantity, localisation and size of metastases and the primary tumour
surgery
radiation of the entire head
stereotactic radiosurgery
chemotherapy

Therapy of Recurrent Brain Metastases

requires individual decision
renewed surgery of brain metastases
second irradiation
chemotherapy

Aftercare of Brain Metastatses

check-ups every three months (CT and/or MRI)
completely oncological aftercare

Course of Brain Metastases

strong tendency to recurrence
rarely local resolution

Prognosis of Brain Metastatses

depending on course of underlying disease
metastases show progression of cancer
without treatment median survival of few weeks
bad prognosis despite therapy
positive prognostic factors: age, controlled primary tumour and no extracranial metastases