title: The ventricular system and choroid plexus as a primary site for renal cell carcinoma metastasis.
abstract: BACKGROUND
  Brain metastases (BM) are the most common intracranial tumours amongst adults. Ten to 40 % of patients with cancer will develop BM. In this study, we observed a high affinity of renal cell carcinoma (RCC) to the ventricular system, with close association to the choroid plexus.
  
  
  METHODS
  This is a retrospective study evaluating data of our prospectively maintained brain tumour database, focusing on consecutive BM patients, who were treated at our center between March 2003 and December 2011. Data collected included primary pathologies, anatomical distribution of the brain metastasis according to neuroimaging, and treatment modalities.
  
  
  RESULTS
  We identified 614 patients with BM, of whom 24 (3.9 %) were diagnosed with RCC, harboring 33 lesions. Nine of the 24 patients (37.5 %) presented with an intraventricular location (10 of 33 RCC BM lesions). Of the remaining 590 patients with non-RCC pathologies, five patients (0.8 %) were diagnosed with intraventricular lesions (p < 0.0001).
  
  
  CONCLUSIONS
  In this unselected, consecutive treated BM patient cohort we observed a high affinity of RCC BM to the ventricular system with close association to the choroid plexus. The reason for this affinity is unknown. Surgical approaches for resection of these lesions should be planned to include early control on the vascular supply from the choroidal vessels.
authors.affiliation: Department of Neurosurgery, Tel Aviv Medical Center, Tel Aviv University School of Medicine, 6 Weizman Street, Tel Aviv, 64239, Israel.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Shapira
authors.forename: Uri P
authors.initials: UP
authors.lastname: Hadelsberg
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Kanner
authors.forename: Zvi
authors.initials: Z
authors.lastname: Ram
authors.forename: Jonathan
authors.initials: J
authors.lastname: Roth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000556:secondary*; D002551:Cerebral Ventricle Neoplasms / Q000556:secondary*; D002831:Choroid Plexus / Q000473:pathology*; D016545:Choroid Plexus Neoplasms / Q000556:secondary*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult