Metastases versus Primary Brain Neoplasms

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Metastases versus Primary Brain Neoplasms

Brain metastasis is the most common neoplastic condition affecting the brain parenchyma. A major differential diagnostic consideration would be a primary high-grade brain neoplasm, which may be indistinguishable. Some features, however, can aid in differentiating these lesions (Table 2.1). Abscesses can also be difficult to differentiate from cystic or necrotic neoplasm and diffusion-weighted imaging can be useful. Abscesses have true restricted diffusion, although hemorrhagic metastasis may also have a similar appearance (see Chapter 1 for further discussion).

The most frequent primary brain tumors in adults are gliomas and primary central nervous system (CNS) lymphomas. Gliomas are classified according to aggressiveness from low-grade glioma to anaplastic astrocytoma and glioblastoma multiforme (characterized by necrosis and hemorrhage).

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