Cancer Res Treat.  2011 Jun;43(2):102-107.

Surgical Outcomes of Hemorrhagic Metastatic Brain Tumors

• Yoo H
• Jung E
• Gwak HS
• Shin SH
• Lee SH

Abstract

PURPOSE
Hemorrhagic metastatic brain tumors are not rare, but little is known about the surgical outcome following treatment. We conducted this study to determine the result of the surgical outcome of hemorrhagic metastatic brain tumors.
MATERIALS AND METHODS
From July 2001 to December 2008, 21 patients underwent surgery for hemorrhagic metastatic brain tumors at our institution. 15 patients had lung cancer, 3 had hepatocellular carcinoma, and the rest had rectal cancer, renal cell carcinoma, and sarcoma. 20 patients had macroscopic hemorrhage in the tumors, and one patient had intracerebral hemorrhage surrounding the tumor. A retrospective clinical review was conducted focusing on the patterns of presenting symptoms and signs, as well as local recurrence following surgery.
RESULTS
Among 21 hemorrhagic brain metastases, local recurrence developed in two patients. The 12 month progression free survival rate was 86.1%. Mean time to progression was 20.8 months and median survival time after surgery was 11.7 months.
CONCLUSION
The results of our study showed that hemorrhagic metastatic brain tumors rarely recurred after surgery. Surgery should be considered as a good treatment option for hemorrhagic brain metastasis, especially in cases with increased intracranial pressure or severe neurologic deficits.

Keyword

Neoplasm metastasis; Brain; Hemorrhage; Local neoplasm recurrences; Surgery

MeSH Terms

Brain
Brain Neoplasms
Carcinoma, Hepatocellular
Carcinoma, Renal Cell
Cerebral Hemorrhage
Disease-Free Survival
Hemorrhage
Humans
Intracranial Pressure
Lung Neoplasms
Neoplasm Metastasis
Neoplasm Recurrence, Local
Neurologic Manifestations
Rectal Neoplasms
Recurrence
Retrospective Studies
Sarcoma

Figure

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  Fig. 1 Distant recurrence free survival curve of hemorrhagic brain metastasis.

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  Fig. 2 Overall survival curve of hemorrhagic brain metastasis.

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  Fig. 3 Overall survival curve of hemorrhagic brain metastasis based on primary cancers.

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  Fig. 4 Illustrative case. A 55-yr-old male with non small cell lung cancer with hemorrhagic brain metastasis showed no local recurrence 49 mo after surgery without postoperative radiation therapy. However, multiple small distant metastases had developed. (A) Pre-operative non-contrast enhanced computed tomography (CT). (B) Pre-operative contrast-enhanced CT. (C) Pre-operative T2-weighted magnetic resonance imaging (MRI). (D) Pre-operative T1-weighted MRI. (E) Pre-operative gadolinium enhanced T1-weighted MRI. (F) Gadolinium enhanced T1-weighted MRI after 49 mo after surgery.

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