Metastatic Carcinoma in the Brain

Pathology:

The specimen is the cerebrum sliced horizontally. On the superior view, the right hemisphere is clearly enlarged, particularly in the parietal region where the gyrae are widened and 3 cystic tumours are evident. The largest, 5 cm in diameter, is in the right parietal region. A smaller tumour, 2 x 1.5 cm in diameter, is seen close to the posterior margin of the largest tumour. A third one, 1.5 cm in diameter, is present in the left parietal region. The tumours have mainly involved white matter. The wall of each lesion is composed of shaggy friable greyish tissue. At necropsy, there was ulceration of the largest tumour into the right lateral ventricle (seen more clearly when the inferior surface is examined). Sub-falcine herniation was also seen, as is displacement of the basal ganglia and internal capsule. Histological examination revealed metastatic carcinoma in the viable areas. Other metastases were found in the liver and bone. Histology of a liver metastasis was consistent with origin from a primary carcinoma of breast.