Intracranial metastases
see Brain metastases.
see Posterior fossa metastases
Evaluation
Deciding which of the following tests are needed to evaluate a patient with multiple intracranial lesions must be individualized for the appropriate clinical setting.
1. cardiac echo: to R/O SBE that could shed septic emboli
2. “Intracranial metastases workup” including:
a) CT of chest/abdomen/pelvis with and without contrast: has become a relatively standard part of the metastatic workup. It has largely supplanted CXR, lower GI (barium enema) and IVP.
Rationale:
● Chest: R/O primary bronchogenic Ca or pulmonary metastases of another Ca. Can demonstrate mediastinal lymphadenopathy. Also to R/O pulmonary abscess that could shed septic emboli
● Assesses for possible primary lesions: e.g. kidneys, GI, prostate
● Evaluates for metastases to liver, adrenal, and even spine
b) mammogram in women
c) PSA in men
Differential diagnosis
see Intracranial metastases differential diagnosis.