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Clinical and therapeutic insights into intraventricular metastases from extracranial solid tumors: Patterns,
Naveen Arunachalam Sakthiyendran1, Daniel Sconzo1, Aryan Wadhwa1
1Department of Neurosurgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA.
Abstract:
Solid intraventricular metastasis from extracranial primary tumors (SIMs) are rare and their diagnosis and management remain poorly understood. A systematic review was conducted using the MEDLINE and Embase databases to identify relevant studies published until November 2024. Data such as presenting symptoms, treatments and survival outcomes were extracted from included articles on patients with SIMs. A total of 26 studies, involving 26 patients (34.6% female patients; median age, 64 years), met the inclusion criteria. The most common primary tumor was renal cell carcinoma (38.5%). Furthermore, 57.7% of patients had metastasis to one or both lateral ventricles, 19.2% had metastasis to the lateral and fourth ventricle, 11.5% had metastasis to the third ventricle alone, 7.7% had metastasis to the lateral and third ventricle, and 3.8% had metastasis to the fourth ventricle alone. Treatment approaches varied, with tumor resection (42.3%) being the most common intervention, followed by tumor resection with adjuvant chemo/radiation therapy (15.4%). The median post-treatment survival time was 4.3 months. Patients receiving tumor resection combined with radiation or chemotherapy had the longest survival (median, 24 months), compared with those undergoing tumor resection alone (median, 2 months). SIMs are rare but clinically significant, with variable treatment approaches and survival outcomes. Multimodal therapy offers the best prognosis, although survival remains generally poor. Further research is needed to better understand the pathophysiology, treatment strategies and outcomes of SIMs.
Insights
Solid intraventricular metastasis (SIMs) from extracranial tumors are rare. Multimodal therapy, including surgery and adjuvant treatments, offers the best prognosis for these challenging brain metastases.
Area of Science:
- Neuro-oncology
- Oncology
- Neurosurgery
Background:
- Solid intraventricular metastasis (SIMs) from extracranial primary tumors are rare and poorly understood.
- Diagnosis and management of SIMs present significant clinical challenges.
Purpose of the Study:
- To systematically review the literature on solid intraventricular metastasis (SIMs).
- To analyze presenting symptoms, treatment strategies, and survival outcomes for patients with SIMs.
Main Methods:
- Systematic review of MEDLINE and Embase databases up to November 2024.
- Inclusion of 26 studies involving 26 patients diagnosed with SIMs.
- Extraction of data on clinical presentation, interventions, and survival.
Main Results:
- Renal cell carcinoma was the most common primary tumor (38.5%).
- Metastasis commonly involved lateral ventricles (57.7%).
- Tumor resection was the most frequent intervention (42.3%), but multimodal therapy (surgery + chemo/radiation) yielded longer survival (median 24 months vs. 2 months).
Conclusions:
- Solid intraventricular metastasis (SIMs) are rare but clinically significant, with varied presentations and outcomes.
- Multimodal therapy provides the best prognosis, though overall survival remains poor.
- Further research is crucial to elucidate pathophysiology and optimize treatment strategies for SIMs.
