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Central nervous system neoplasms
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
Lung cancer is responsible for the majority of brain metastases, with the remainder accounted for by breast, renal, colorectal and melanoma. Most commonly, brain metastases are found in patients already known to have cancer; however, they may be found at the same time or before the primary cancer is found.6,7
Stroke and Transient Ischemic Attacks of the Brain and Eye
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Intracardiac tumors include myxomas and valvular fibroelastomas. Myxomas are most frequently found in the left atrium. Some are familial. Tumor or associated thrombus may embolize to the brain, eye, and elsewhere. Myxomatous emboli may not only cause focal cerebral ischemia but also aneurysmal dilation at sites of earlier emboli. These mycotic aneurysms can rupture and cause intracranial hemorrhage. Brain metastases have also been described. Myxomas also can obstruct cardiac outflow and cause syncope. Frequently, there are associated constitutional symptoms, such as malaise, fatigue, weight loss, fever, rash, arthralgia, myalgia, anemia, raised erythrocyte sedimentation rate (ESR), and hypergammaglobulinemia.
Malignant Melanoma
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Approximately 30–60% of patients with stage IV melanoma develop brain metastases. In a series of 686 patients with treated brain metastasis, median survival from the time of diagnosis of cerebral metastasis was 4.1 months.46 Management of brain metastases has been difficult given the resistance to cytotoxic chemotherapy and radiotherapy. Current treatment modalities include surgery, radiotherapy (whole-brain and stereotactic irradiation), targeted therapy, and immunotherapy.
In vivo dynamics and anti-tumor effects of EpCAM-directed CAR T-cells against brain metastases from lung cancer
Published in OncoImmunology, 2023
Tao Xu, Philipp Karschnia, Bruno Loureiro Cadilha, Sertac Dede, Michael Lorenz, Niklas Seewaldt, Elene Nikolaishvili, Katharina Müller, Jens Blobner, Nico Teske, Julika J. Herold, Kai Rejeski, Sigrid Langer, Hannah Obeck, Theo Lorenzini, Matthias Mulazzani, Wenlong Zhang, Hellen Ishikawa-Ankerhold, Veit R. Buchholz, Marion Subklewe, Niklas Thon, Andreas Straube, Joerg-Christian Tonn, Sebastian Kobold, Louisa von Baumgarten
Brain metastases arise from hematogenous dissemination of malignant cells from an extracranial neoplasm to the cerebral vasculature. Patients with lung cancer are at a particularly high risk, and 30–50% of affected individuals are expected to develop brain metastases during the course of their disease.1, 2 This number might even increase in the next decades given that therapeutic advances for lung cancer involving immunotherapeutic or targeted agents have resulted in prolonged disease courses.3 Although control of extracranial disease can often be achieved using such agents, a considerable number of patients succumb to their intracranial tumor.4 Novel therapeutic strategies for the treatment of lung cancer brain metastases are therefore urgently warranted.
Alveolar soft tissue sarcoma: a report of 50 cases at a single institution
Published in Acta Chirurgica Belgica, 2023
Pengyuan Zhao, Huixiang Li, Huayan Ren
All of the patients with metastatic ASPS at the first visit (n = 22, 44%) had lung metastases, and patients with localized disease developed lung metastases during the follow-up period (n = 9, 18%), with a total incidence of lung metastasis of 62%. After the initial diagnosis of ASPS, lung metastases were detected at a median interval of 31 months (2–91 months) in patients with localized disease. Among the patients with localized disease, the lung metastasis rates at 2, 3 and 5 years were 17%, 29%, and 41%, respectively. In the univariate and multivariate statistical analyses, we found that only tumor size was a valuable prognostic factor for lung metastasis in patients with ASPS (Table 2). The 5-year survival rates of patients with and without lung metastases were 76.3% and 100%, respectively (p = 0.06 > 0.05). Additionally, 8 (16%) patients developed brain metastases with a median interval from the initial diagnosis of 16.5 months (0–91 months). After the onset of brain metastasis, five patients died from the disease, with a median OS of 13 months (2–38 months). We did not find prognostic factors associated with brain metastasis, and the 5-year survival rates of patients with and without brain metastases were 38.1% and 97%, respectively (p = 0.003).
Characterization of plasma circulating small extracellular vesicles in patients with metastatic solid tumors and newly diagnosed brain metastasis
Published in OncoImmunology, 2022
Alberto Carretero-González, Marta Hergueta-Redondo, Sara Sánchez-Redondo, Pilar Ximénez-Embún, Luis Manso Sánchez, Eva Ciruelos Gil, Daniel Castellano, Guillermo de Velasco, Héctor Peinado
Tumor-secreted EVs have the intrinsic ability to breach biological barriers such as the BBB.41 Brain metastases, result from the dissemination of tumor cells to the brain, most commonly from lung cancer, melanoma, and breast cancer.1,2 EVs contribute to different stages of brain metastasis increasing BBB permeability,21,41 reprogramming of brain metastatic niches20,42 and increasing brain metastatic organotropism of tumor cells.18,19 Overall, these studies demonstrate that EVs can drive bidirectional cross talk between tumor cells and their microenvironment promoting metastasis formation in the brain. However, the analysis of EVs in clinical samples is unreported, to the best of our knowledge, this study constitutes the first approach to characterize the potential clinical value of a noninvasive technique, liquid biopsy using plasma-circulating sEVs, in patients with different solid tumors and recently diagnosed brain metastases.