About 10 to 50% of patients with systemic malignancy develop brain metastases during the course of their disease. Metastases account for more than half of all brain tumors in adults. The majority of patients have multiple metastases. A long disease-free interval, with absent systemic metastatic disease and presentation of brain metastases of unknown primary, may require biopsy of the brain lesion if active treatment is appropriate.
Up to one-third of brain metastases are discovered on routine staging investigations, the majority presenting with varying clinical features. The diagnosis of brain tumors should be suspected in any cancer patient who develops any new neurological symptoms. Brain metastases present with headaches in 40–50% of patients, with increased frequency with multiple metastases or posterior fossa metastases. Seizures and behavioral symptoms are also common while, in…
