The role of magnetic resonance imaging in children with hematogenous brain metastases from primary solid tumors.

Within a 10-year period, 4 out of 429 children with solid tumors treated at the pediatric oncology department developed brain metastases. Lesions secondary to direct extension from the skull or dura were excluded. The tumors causing brain metastases were non-small cell lung carcinoma, Wilms' tumor, osteosarcoma, und hepatoblastoma. All patients had single brain metastasis. All tumors were subcortical/cortical based and isointense on T1-images and, in 2 cases, mildly hyperintense on T2-images. Two patients showed diffusion abnormalities. Three showed enhancement. In the patient with osteosarcoma, metastasis was calcified. Central nervous system (CNS) metastasis may not in itself be a terminal event; metastasis in patients with Wilms' tumor might behave differently. Neuroimaging should be considered in children with pediatric solid tumors with neurological symptoms on follow up.