Metastasis in central nervous system: Clinicopathological study with review of literature in a tertiary care center in South India.
BACKGROUND
Secondary central nervous system (CNS) tumors are common in Western countries, but in Indian literature, scant data are available. With the advent of newer imaging techniques, the confirmatory histopathological diagnosis has become comparatively easier. Hereby, we have analyzed our data from a single tertiary care center in south India.


METHODS
In this retrospective study from January 2000 to December 2010, histopathologically diagnosed secondary CNS tumors were reviewed along with clinical, imaging, and relevant immunohistochemical findings. Meningeal, lymphoproliferative, and myeloproliferative tumors and autopsy data were not included in the study group.


RESULTS
There were 40 secondary CNS tumors. Male to female ratio was 2.3:1. Age range was wide (28-75 years). Majority of cases were seen in the fourth and fifth decade. Imaging-wise, (computed tomography and magnetic resonance imaging) majority were single lesions (n = 34, 85%). Most commonly, these single lesions were present in the cerebral hemisphere (n = 20, 50%) followed by cerebellum (n = 10, 25%). Adenocarcinoma accounted for maximum number of cases (n = 25, 62.5%) with lungs being the most common primary.


CONCLUSIONS
We have noted 25% metastatic adenocarcinomas in cerebellar location, which is higher when compared with available world literature. However, we also encountered a good number of cases (30%) due to unknown primary. Though histopathological examination with use of immunohistochemical markers can reliably distinguish primary from secondary CNS tumors in addition to available clinical and imaging data, particularly in developing countries, still a better work-up with an array of immunohistochemical markers and newer imaging modalities is desirable.
Department of Pathology, Sri Venkateswar Institute Of Medical Sciences, Tirupati, Andhra Pradesh, India.
Rashmi
R
Patnayak
Department of Surgical Oncology, Sri Venkateswar Institute Of Medical Sciences, Tirupati, Andhra Pradesh, India.
Amitabh
A
Jena
Department of Radiology, Sri Venkateswar Institute Of Medical Sciences, Tirupati, Andhra Pradesh, India.
Bodagala
B
Vijaylaxmi
Department of Radiology, Sri Venkateswar Institute Of Medical Sciences, Tirupati, Andhra Pradesh, India.
Amancharla Y
AY
Lakshmi
Department of Neurosurgery, Sri Venkateswar Institute Of Medical Sciences, Tirupati, Andhra Pradesh, India.
Bcm
B
Prasad
Department of Pathology, Sri Venkateswar Institute Of Medical Sciences, Tirupati, Andhra Pradesh, India.
Amit Kumar
AK
Chowhan
Department of Pathology, Sri Venkateswar Institute Of Medical Sciences, Tirupati, Andhra Pradesh, India.
N
N
Rukmangadha
Department of Pathology, Sri Venkateswar Institute Of Medical Sciences, Tirupati, Andhra Pradesh, India.
Bobbit V
BV
Phaneendra
Department of Pathology, Sri Venkateswar Institute Of Medical Sciences, Tirupati, Andhra Pradesh, India.
Mandyam Kumaraswamy
MK
Reddy
Immunohistochemistry; metastasis; pathology; secondary central nervous system tumors