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Metastasis is the most common cause of brain cancer, as primary tumors that originate in the brain are less common. [4] The most common sites of primary cancer which metastasize to the brain are lung, breast, colon, kidney, and skin cancer. Brain metastases can occur months or even years after the original or primary cancer is treated.
Lung cancer is the most diagnosed and deadliest cancer worldwide, with 2.2 million cases in 2020 resulting in 1.8 million deaths. [3] Lung cancer is rare in those younger than 40; the average age at diagnosis is 70 years, and the average age at death 72. [2] Incidence and outcomes vary widely across the world, depending on patterns of tobacco use.
Secondary, or metastatic, brain tumors are about four times as common as primary brain tumors, [2] [10] with about half of metastases coming from lung cancer. [2] Primary brain tumors occur in around 250,000 people a year globally, and make up less than 2% of cancers. [3]
It is also known as myasthenic syndrome, Eaton–Lambert syndrome, and when related to cancer, carcinomatous myopathy. [2] Around 60% of those with LEMS have an underlying malignancy, most commonly small-cell lung cancer; it is therefore regarded as a paraneoplastic syndrome (a condition that arises as a result of cancer elsewhere in the body). [3]
Metastasis occurrence indicates stage 4 cancer progression and carries a poor prognosis. [7] Cancer usually causes numerous and varying symptoms at this stage depending on the underlying cancer and metastasis location. [7] Importantly for diagnosis, a symptomatic primary lesion is localised through either surgery or radiation. [7]
The most common symptoms of CNS tumors are headache, vomiting, and nausea. Symptoms vary depending on the tumor and may include unsteady gait, slowed speech, memory loss, loss of hearing and vision, problems with memory, narrowing of visual field, and back pain. Symptoms may also vary greatly between individuals with the same tumor type.
Most patients with limited-stage small cell lung cancer will receive a CT scan of the chest and abdomen to search for abnormality within the lungs and lymph nodes, as well as abnormal areas in more distal organs such as adrenal glands and liver that might arise from the metastasis of lung cancer. [15]
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.
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