Considerations on the metastatic tumours of the brain with reference to a statistics of 1217 cases.

In 1217 patients with metastatic tumors of the brain (MTB) (13% of the 1935-1973 endocranial tumour statistics of the Neurosurgical Clinic, Bucharest) the lung was, found to be the most frequent location of the primary tumour in males and the breast in women. The MTBs preponderantly affected males (65%); the most frequent cases (63%) were aged from 41 to 60. In 46% of the cases the metastatic tumour was solitary while in 80% it was supratentorial located in the frontal (37%), parietal (31%), temporal (23%) and occipital (9%) lobes. The latent period varied from a few days to 16 years but mostly from one month to one year. The onset of the symptoms was chiefly the slowly progressive one (71%). The initial symptom by frequency order was raised intracranial pressure, epilepsy (especially focal) and motor loss. Symptoms at acme and clinical forms are reviewed also. The paraclinical investigations which proved the most contributory were scintigraphy and ventriculography. The most therapeutic step proved to be total ablation, single metastatic tumours being removed even before the primary one. Immediate postoperative death rate was 17% while the rate of a 6- to 8-month survival after surgery was 70%, though cases were also recorded which survived several years quite satisfactorily. Having long been neglected by specialists, the metastatic tumours of the brain (MTB) received attention especially in the past two decades. Their frequency, diagnosis and therapy prove as important as those of any other brain tumour.