Brain metastasis of renal adenocarcinoma

Among 1,828 autopsy cases of adenocarcinoma reviewed, 177 cases (9.7%) were found to have brain metastasis, and their autopsy records were analyzed to investigate the mode of dissemination of the cancer to the brain. Brain metastases were most frequent in the age group of 50-59 years but showed no significant difference in incidence between sexes or location (right or left) of the primary lesion. The cases with brain metastases had greater frequencies of metastases in the lungs, heart, thyroid and skull than cases without brain metastases. Lung metastasis was most frequent in cases with two-organ metastases, and lung metastasis with involvement of the hilar lymph nodes in cases with three-organ metastases. Metastasis to the brain was significantly more frequent in nephrectomized cases than in non-nephrectomized cases. Metastases to the contralateral kidney and peritoneum were significantly more frequent in nephrectomized cases with brain metastasis. Possible routes of dissemination of the cancer to the brain are discussed.