Metastatic brain tumor involves a mass of cancerous cells in the brain that have spread from another part of the body.

Metastatic (secondary) brain tumor occurs when there is a tumor in an area of the body, most commonly the lungs or the breast, and cells from that tumor break off, travel in the bloodstream (metastasize), and lodge in the brain. Other tumors that commonly spread to the brain include melanoma, kidney cancer, and germ cell tumors (such as testicular or ovarian cancers).

Tumors may be localized to a small area, invasive (spread to nearby areas), benign (noncancerous) or malignant (cancerous). They can directly destroy brain cells, or they may indirectly damage cells by producing inflammation, compressing other parts of the brain as the tumor grows, inducing cerebral edema (brain swelling), and causing increased intracranial pressure (the pressure within the skull).

Classification of metastatic brain tumors depends on the exact site of the tumor within the brain, type of tissue involved, original location of the tumor, and other factors.

Metastatic brain tumors occur in about one-fourth of all cancers that metastasize (spread through the body). They are much more common than primary brain tumors. They occur in approximately 10-30% of adult cancers.

• Headache
  • Recent onset of new type
  • Persistent
• Vomiting, may or may not be accompanied by nausea
• Personality changes
• Emotional instability, rapid emotional changes
• Intellectual decline
  • Memory loss
  • Calculating deficiencies
  • Impaired judgment
• Seizures, new onset
• Neurologic losses, one or more
  • Vision changes, double vision, decreased vision
  • Changes in sensation of a body area
  • Weakness of a body area
  • Speech difficulties
  • Decreased coordination, clumsiness, falls
• Fever (sometimes)
• Lethargy
• General ill feeling (malaise)
• Eyes, pupils different size

• A head CT scan or MRI of the head confirms the diagnosis of brain tumor and localizes the tumor.
• Cerebral angiography is occasionally performed. It may show a space-occupying mass, which may or may not be highly vascular (filled with blood vessels).
• A chest X-ray, mammogram, and other tests are performed to look for the original site of the tumor.
• An EEG may reveal focal (localized) abnormalities.
• An examination of tissue removed from the tumor during surgery or CT scan-guided biopsy is used to confirm the exact type of tumor. If the primary tumor can be located outside of the brain, the primary tumor is usually biopsied rather than the brain tumor.
• A lumbar puncture (spinal tap) is sometimes also performed to test the cerebral spinal fluid.

Treatment varies with the size and type of the tumor, the initial site of the tumor and the general health of the person. The goals of treatment may be relief of symptoms, improved functioning, or comfort.

Surgery may be used for metastatic brain tumors when there is a single lesion in some cancers and when there is no cancer elsewhere in the body. Some may be completely excised (removed). Tumors that are deep or that infiltrate brain tissue may be debulked (removal of much of the mass of the tumor to reduce its size).

Surgery may reduce intracranial pressure and relieve symptoms in cases when the tumor cannot be removed. Radiation therapy may be advised for tumors that are sensitive to radiation.

Medications may include the following:

• Corticosteroids such as dexamethasone to reduce swelling of the brain
• Osmotic diuretics such as urea or mannitol to reduce brain swelling
• Anticonvulsants such as phenytoin to reduce seizures
• Analgesics to control pain
• Antacids or antihistamines to control stress ulcers
• Chemotherapy

• Brain herniation (fatal)
• Permanent, progressive, profound neurologic losses
• Loss of ability to interact
• Loss of ability to function or care for self

Call for an appointment with your health care provider if new, persistent headaches occur.

Call your health care provider or go to the emergency room if seizures develop, or if there is the sudden development of stupor, vision changes, or speech impairment.