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R. R. Strang and H. Nordenstam

involved the cerebral hemispheres. Isolated cases of intracerebral metastases 19 and of extracranial metastases 12 have been reported. Oligodendrogliomas are also exceedingly rare in the cerebellum 30 and spinal cord. 1, 10, 13, 14, 22, 26 Cairns and Russell 6 examined the spinal cords of patients with cerebral gliomas and found evidence of metastases in more than one third of the cases. Wolf 28 stated that spinal metastases from brain tumors constituted 4 per cent of all neoplasms of the cord. Wood et al . 29 also described spinal metastases from intracerebral

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R. Lewis Wright, Beth Shaumba and Judy Keller

T here are now a number of reports on the effect of deprivation or supplementation of glucocorticosteroids on the growth of certain malignant tumors. Data have been obtained on several experimental neoplasms as well as on a number of human tumors. The responses of tumors to these alterations have varied. Delayed growth has been observed as have enhanced growth and metastases in other instances. Some tumors have shown no response. Two decades ago it was noted that administration of glucocorticosteroids to patients with intracerebral metastases of breast

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Robert A. Beatty

. Microscopic sections of the spinal cord and cerebral metastases again confirmed the melanin-containing epithelial cells in papillary-like arrangements ( Fig. 3 ). Fig. 2. Postmortem specimens. Left: Spinal cord showing the finely peppered appearance of the metastases. Right: Horizontal section of the brain showing intracerebral metastases and probable regrowth of the primary tumor in the atrium of the left lateral ventricle. Fig. 3. Photomicrograph of the cerebral metastasis adjacent to the normal brain in upper right. Papillary structures are

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Matthew F. Omojola, Allan J. Fox, Roland N. Auer and Fernando V. Viñuela

cooperative clinical trial. J Neurosurg 49 : 333 – 343 , 1978 Walker MD, Alexander E Jr, Hunt WE, et al: Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J Neurosurg 49: 333–343, 1978 22. West CR , Yamada K , Karakousis CP , et al : Intraarterial BCNU infusion for intracerebral metastases from malignant melanoma and lung cancer. Proc Am Assoc Cancer Res 20 : 332 , 1979 (Abstract) West CR, Yamada K, Karakousis CP, et al: Intraarterial BCNU

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Intramedullary spinal cord metastasis

A clinicopathological study of 13 cases

Donal A. Costigan and Marc D. Winkelman

spinal cord appears in parentheses. Edelson, et al. , 5 have suggested that the frequency of ISM is higher than might be expected. 5 They compared the ratio of spinal cord weight to brain weight (2%) with the ratio of the number of patients with ISM to the number of patients with metastases to brain and cord combined (5%), using data from the autopsy series of Chason, et al. , 4 and concluded that the spinal cord was more susceptible to invasion than the CNS as awhole. However, by neglecting to take into consideration multiple, uncounted intracerebral

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Paul Steinbok, Clarisse L. Dolman and James H. Goldie

In humans, intracerebral metastases progressed while tumor in systemic sites was responding to adriamycin. 1 Our patient is the first in whom a documented systemic metastasis from a glioblastoma has been shown to regress with the use of a nitrosourea while the intracerebral tumor continued to grow. Possible explanations include inadequate drug delivery to the intracranial tumor, different sensitivities of the intra- and extracerebral tumors, or a combination of these factors. It was interesting that, whereas the tumor in the brain was made up of large and small

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Fred H. Hochberg, Amy A. Pruitt, Deborah O. Beck, Gerard DeBrun and Kenneth Davis

, Byar DP , et al : Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med 303 : 1323 – 1329 , 1980 Walker MD, Green SB, Byar DP, et al: Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med 303: 1323–1329, 1980 16. West CR , Yamada K , Karakousis CP , et al : Intra-arterial BCNU infusion for intracerebral metastases from malignant melanoma and lung cancer. Proc Am Assoc

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Joseph A. Frank, Mary Girton, Andrew J. Dwyer, Paul J. Cohen, Richard H. Knop, Richard Diggs, Joseph Cobb and John L. Doppman

) developed intracerebral metastases, resulting in a reproducibility rate of 96% (24 of 25 animals) overall and 100% for the larger inoculum dose. Ocular metastasis developed in 92% (22 of 24 animals), with one failure at each dose of tumor cells. Tumor implantation in the anterior ocular chamber was visible in 80% (19 of 24 animals), presenting as erythema or injection of the conjunctiva, sclera, or iris. All rabbits that received the larger dose of inoculum (10 6 cells) were dead within 15 days. Thirteen of the 24 animals with metastases were sacrificed between Days 11

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the occurrence of ocular metastases, which pre- cede the appearance of intracerebral metastases in 92% of the animals. This confirms the presence of tumor growth and allows an investigator to start an interventional procedure early in the course of the VX2 tumor's intracerebral growth rather than wait until signs of metastatic disease appear. Based on ocular findings, we have treated three rabbits infused intra-arterially with 10 6 VX2 tumor cells with standard fractionated radiation therapy (3000 rads/10 fractions). These animals developed neurological deficits 24

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William T. Couldwell, Parakrama T. Chandrasoma and Martin H. Weiss

possible and contiguous spread through Virchow-Robin spaces allows intracerebral metastases to occur. Varkarakis, et al. , 13 however, invoked a multistep cascade process in the genesis of cerebral metastases, whereby pulmonary and bone involvement precede neural metastases. This has been advocated as the more common method of spread, supported clinically by the usual evidence of multiplesystem involvement at the time of presentation of symptomatic cerebral metastasis. A contradiction is the solitary brain metastasis in the absence of other organ involvement, as