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Treatment for brain metastases is primarily palliative, with the goals of therapy being reduction of symptoms and prolongation of life. However, brain metastases harboring a mutation in the BRAF kinase at position V600 are effectively druggable with small molecule inhibitors such as dabrafenib.
Metastatic melanoma may cause nonspecific paraneoplastic symptoms, including loss of appetite, nausea, vomiting, and fatigue. Metastasis (spread) of early melanoma is possible, but relatively rare; less than a fifth of melanomas diagnosed early become metastatic. Brain metastases are particularly common in patients with metastatic melanoma. [17]
Secondary tumors of the brain are metastatic and have spread to the brain from cancers originating in another organ. Metastatic spread is usually by the blood. The most common types of cancers that spread to the brain are lung cancer (accounting for over half of all cases), breast cancer, melanoma skin cancer, kidney cancer and colon cancer. [62]
Clinically, CNS metastasis is known to cause haemorrhage or obstruction in the cranial portion of the CNS leading to hydrocephalus. [9] Additionally, metastatic lesions are usually discrete within the brain and appear as spherical masses that displace the brain parenchyma rather than invading the tissues. [10]
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Brain metastasis can be single or multiple and involve any portion of the brain. Metastasis to dural structures generally occurs by hematogenous spread or direct invasion from a contiguous bone. Dural metastases can invade the underlying brain and cause focal edema and associated neurologic symptoms. These processes tend to cause seizures early ...
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