Multiple Metastatic Tumours in the Brain arising from Primary Bronchial Carcinoma.

Abstract

THE clinical and pathological investigation of multiple metastatic tumours of the brain arising from primary bronchial carcinomas is full of snares and pitfalls for the neurological physician, surgeon and pathologist; and, although bronchogenic carcinoma with secondary growths in the brain produces a now fairly well recognized and not uncommon syndrome, its diagnosis is still sometimes made only in the post-mortem room; and even there difficulties may occasionally arise in its recognition. Ten years ago, in a text-book 1 for which one of us, together with Professor J. M. Beattie, was responsible, the statement was made that 'Primary tumours of the lung are extremely rare. Osteomas, chondromas, and sarcomas occur, but the most usual primary tumours are columnar-celled cancers-originating, probably, from some part of the bronchi or from the mucous glands '; while under the heading ' Tumours of the Brain ' we merely stated that 'Secondary cancer is also rare.' Similarly, Ewing, in the third edition (1928) of his book, Neoplastic Diseases, p. 851, gives the frequency of primary malignant tumours of the lung at about 1 per cent. of all cancers, his statistics being taken from between 16,000 and 17,000 autopsies on cancer cases. These statements now require modification, as both in our own experience and in that of others, the frequency of bronchial carcinomas-whether they are described as such or as ' Oat-celled Sarcoma of the Mediastinum ' 2 3: as' Tumours of the Mediastinum and Lung' 4: as' Primary Lung Tumours,' 5