Site preference of metastatic tumours of the brain

Amongst 15,000 autopsies performed between 1969 and 1984 in the Department of Pathology of the University Hospital of Innsbruck (Austria) 237 cases (1.6%) with brain metastases were found. The mean age of patients was 61.2 years and 148 patients out of 230 cases with satisfactory records were male (64.3%). Multiple lesions were found in 58%. In absolute figures carcinoma of the lung, followed by malignant melanoma and breast carcinoma were, as in other series, the most frequent primary site for brain metastases. The relative frequency of brain metastases in various anatomical regions of the brain showed that malignant melanoma tends to metastasize to the frontal and temporal lobes, breast carcinoma to the cerebellum and the basal ganglia, large cell carcinoma of the lung to the occipital lobe and squamous cell carcinoma of the lung to the cerebellum. Metastases of small cell carcinoma of the lung were found equally distributed in all regions of the brain. Our study supports the results of several experimental investigations, suggesting the possibility that specific cell surface properties of metastasizing tumour cells and particular properties of the vascular endothelium of the target organs of metastasis are responsible for the location of metastases. The results of this study suggest that there are substantial differences in regard to these properties even within one target organ.