J Pathol Transl Med.  2023 Jul;57(4):217-231. 10.4132/jptm.2023.06.10.

Single-center study on clinicopathological and typical molecular pathologic features of metastatic brain tumor

• Kim SH
• Lee YS
• Lee SH
• Sung YE
• Lee A
• Kang J
• Park JS
• Jeun SS
• Lee YS

• KMID: 2544329
• DOI: http://doi.org/10.4132/jptm.2023.06.10

Abstract

Background
The metastatic brain tumor is the most common brain tumor. The aim of this study was to demonstrate the clinicopathological and molecular pathologic features of brain metastases (BM).
Methods
A total of 269 patients were diagnosed with BM through surgical resection at Seoul St. Mary’s Hospital from January 2010 to March 2020. We reviewed the clinicopathological features and molecular status of primary and metastatic brain tissues using immunohistochemistry and molecular pathology results.
Results
Among 269 patients, 139 males and 130 females were included. The median age of primary tumor was 58 years (range, 13 to 87 years) and 86 patients (32.0%) had BM at initial presentation. Median BM free interval was 28.0 months (range, 1 to 286 months). The most frequent primary site was lung 46.5% (125/269), and followed by breast 15.6% (42/269), colorectum 10.0% (27/269). Epidermal growth factor receptor (EGFR) mutation was found in 50.8% (32/63) and 58.0% (40/69) of lung primary and BM, respectively. In both breast primary and breast cancer with BM, luminal B was the most frequent subtype at 37.9% (11/29) and 42.9% (18/42), respectively, followed by human epidermal growth factor receptor 2 with 31.0% (9/29) and 33.3% (14/42). Triple-negative was 20.7% (6/29) and 16.7% (7/42), and luminal A was 10.3% (3/29) and 7.1% (3/42) of breast primary and BM, respectively. In colorectal primary and colorectal cancer with BM, KRAS mutation was found in 76.9% (10/13) and 66.7% (2/3), respectively.
Conclusions
We report the clinicopathological and molecular pathologic features of BM that can provide useful information for understanding the pathogenesis of metastasis and for clinical trials based on the tumor’s molecular pathology.

Keyword

Brain metastases; Clinical pathology; Molecular pathology

Figure

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  Fig. 1. Expression patterns of hormone receptors and HER2 in primary tumors and brain metastases by immunohistochemistry. (A) ER expression pattern. (B) PR expression pattern. (C) HER2 expression pattern. ER, estrogen receptor; PR, progesterone receptor; HER2, human epidermal growth factor receptor 2.

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  Fig. 2. Subtype conversion between primary tumor and brain metastases. P, primary tumor; BM, brain metastasis; HER2, HER2-enriched subtype.

Reference

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