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​Brain Metastases (Metastatic Brain Tumors)

What are Brain Metastases?

Brain metastases, also called metastatic brain tumors or secondary brain tumors, originate from cancer cells in another part of the body that have spread to the brain from such regions as the lungs or breasts.

Metastatic brain tumors may appear anywhere in the brain, but are most commonly found at the junction of gray matter and white matter.

What is a brain tumor?

A brain tumor is an abnormal growth of tissue within the brain or central spin. These tumors can disrupt proper brain function. Brain tumors cause a wide range of health problems, from headaches, to loss of consciousness, and in some cases, death.

Symptoms of metastatic brain tumors include vomiting, frequent headaches, and changes in personality. Treatments for brain metastases vary, depending on the type and location.

The neurosurgical team at UPMC may recommend a combination of surgical and non-surgical approaches for treating brain metastases:

  • Endoscopic Endonasal Approach (EEA): The preferred surgical treatment for metastases in the skull base is the Endoscopic Endonasal Approach. This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. Benefits of EEA include no incisions to heal, no disfigurement, and faster recovery time.
  • Neuroendoport® surgery: The preferred surgical treatment for metastatic tumors in the ventricles or deep in the substance of the brain is Neuroendoport surgery. This gives surgeons access to the tumor through a dime-size channel. This minimally invasive approach offers benefits such as minimal scarring, fewer side effects and complications, and faster recovery times than with traditional surgery. 
  • Gamma Knife® radiosurgery: The preferred treatment for metastatic brain tumors is often stereotactic radiosurgery using the Gamma Knife. This painless procedure uses hundreds of highly focused radiation beams to target brain tumors and lesions, with no surgical incision.

Diagnosing Brain Metastases

To diagnose brain metastases, your doctor will:

  • Perform a physical exam.
  • Ask you about your symptoms.
  • Order diagnostic tests.

Symptoms of brain metastases

Symptoms may vary, depending on the size and location of the tumor.

Common brain metastases symptoms may include:

  • Frequent headaches
  • Vomiting
  • Loss of appetite
  • Changes in personality
  • Seizures
  • Memory problems

Tests for diagnosing brain metastases

In addition to a physical exam, your doctor may request imaging studies such as MRI or CT scans.

Brain Metastases Treatments

Treatments vary, depending on the type and location of your brain tumor.

The three standard treatments are:

  • Surgery
  • Radiation therapy including stereotactic radiosurgery
  • Chemotherapy

Your doctor may recommend one or a combination of these treatments.

Minimally invasive surgery for brain metastases

Whenever possible, surgeons will remove brain metastases. The type of surgical treatment depends on the size and location of the tumor.

Several minimally invasive surgical options allow UPMC surgeons to access brain metastases that previously were difficult or impossible to reach.

Metastatic tumors in the skull base or upper spine may be approached directly using the Endoscopic Endonasal Approach (EEA). This state-of-the-art, minimally invasive approach allows surgeons to access the tumor through the natural corridor of the nose, without making an open incision. Surgeons then remove the tumor through the nose and nasal cavities.

EEA offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time. If you need complementary treatments, such as radiation, those therapies can begin soon after EEA surgery.

Neuroendoport® surgery offers a minimally invasive option for tumors within the ventricles (fluid spaces) or deep-seated tumors within the substance of the brain. A narrow tube or port allows surgeons to access these tumors through a tiny incision in the scalp, in contrast to traditional brain surgery.

Radiation therapy for brain metastases

Radiation is a common treatment for brain metastases, since surgery isn't always an option.

We deliver radiation therapy:

  • Externally, by directing radiation at the tumor from an outside source.
  • Internally, by placing radioactive material directly in the body near the cancer.
  • Using stereotactic radiosurgery, such as the Gamma Knife®, by sending a concentrated dose of radiation directly to the brain tumor.

Gamma Knife radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incision.

As the nation's leading provider of Gamma Knife procedures, UPMC has treated more than 12,000 patients with tumors, vascular malformations, pain, and other functional problems.

Chemotherapy for cancerous brain metastases

Chemotherapy uses drugs to stop the growth of cancer cells.

Depending on the type and stage of brain cancer, chemotherapy may be taken by mouth, injected, or placed directly into the brain tumor.

Endoscopic Endonasal Approach (EEA)
Pituitary Tumor Removal Using the Endoscopic Endonasal Approach (EEA) at UPMC

Neuroendoport® Surgery
This animation illustrates the removal of a metastasis using the Neuroendoport technique.

Gamma Knife Radiosurgery
Dr. L. Dade Lunsford discusses Gamma Knife Radiosurgery.

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