Brain Tumor Res Treat.  2015 Apr;3(1):1-7. 10.14791/btrt.2015.3.1.1.

Characteristics and Treatments of Large Cystic Brain Metastasis: Radiosurgery and Stereotactic Aspiration

• Kim M
• Cheok S
• Chung LK
• Ung N
• Thill K
• Voth B
• Kwon DH
• Kim JH
• Kim CJ
• Tenn S
• Lee P
• Yang I

• KMID: 1882004
• DOI: http://doi.org/10.14791/btrt.2015.3.1.1

Abstract

Brain metastasis represents one of the most common causes of intracranial tumors in adults, and the incidence of brain metastasis continues to rise due to the increasing survival of cancer patients. Yet, the development of cystic brain metastasis remains a relatively rare occurrence. In this review, we describe the characteristics of cystic brain metastasis and evaluate the combined use of stereotactic aspiration and radiosurgery in treating large cystic brain metastasis. The results of several studies show that stereotactic radiosurgery produces comparable local tumor control and survival rates as other surgery protocols. When the size of the tumor interferes with radiosurgery, stereotactic aspiration of the metastasis should be considered to reduce the target volume as well as decreasing the chance of radiation induced necrosis and providing symptomatic relief from mass effect. The combined use of stereotactic aspiration and radiosurgery has strong implications in improving patient outcomes.

Keyword

Brain; Metastases; Radiosurgery; Drainage

MeSH Terms

Adult
Brain*
Drainage
Humans
Incidence
Necrosis
Neoplasm Metastasis*
Radiosurgery*
Survival Rate

Figure

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  Fig. 1 Axial and coronal contrast-enhanced T1-weighted magnetic resonance images of the brain of a 66-year-old woman with a large cystic brain metastasis, with hemorrhage, that developed from non-small lung cancer. A: Before aspiration the initial cyst volume was 25.5 cc. B: After cyst aspiration, cyst volume was 5.5 cc. The prescription dose was 20 Gy and MR shows 6 years after postoperatively.

• 

  Fig. 2 Axial and coronal contrast-enhanced T1-weighted magnetic resonance images of the brain of a 73-year-old woman with a large cystic brain metastasis, that developed from breast cancer. A: Before aspiration the cyst volume was 43.2 cc. B: After cyst aspiration, cyst volume was 18.9 cc. The prescription dose was 18 Gy and MR shows about 10 postoperative months.

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