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Sarcoma
Volume 2014 (2014), Article ID 475175, 19 pages
http://dx.doi.org/10.1155/2014/475175
Review Article

Brain Metastasis in Bone and Soft Tissue Cancers: A Review of Incidence, Interventions, and Outcomes

1College of Medicine, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH 44272, USA
2Department of Medicine, Summa Health System, Akron, OH 44303, USA
3Johns Hopkins School of Public Health, Baltimore, MD 21205, USA
4Department of Physical Medicine and Rehabilitation, Rush University Medical Center, Chicago, IL 60612, USA
5Department of Neurosurgery, George Washington University, Washington, DC 20037, USA
6Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA

Received 30 September 2013; Revised 19 January 2014; Accepted 22 January 2014; Published 16 March 2014

Academic Editor: Shreyaskumar Patel

Copyright © 2014 Faris Shweikeh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bone and soft tissue malignancies account for a small portion of brain metastases. In this review, we characterize their incidence, treatments, and prognosis. Most of the data in the literature is based on case reports and small case series. Less than 5% of brain metastases are from bone and soft tissue sarcomas, occurring most commonly in Ewing’s sarcoma, malignant fibrous tumors, and osteosarcoma. Mean interval from initial cancer diagnosis to brain metastasis is in the range of 20–30 months, with most being detected before 24 months (osteosarcoma, Ewing sarcoma, chordoma, angiosarcoma, and rhabdomyosarcoma), some at 24–36 months (malignant fibrous tumors, malignant peripheral nerve sheath tumors, and alveolar soft part sarcoma), and a few after 36 months (chondrosarcoma and liposarcoma). Overall mean survival ranges between 7 and 16 months, with the majority surviving < 12 months (Ewing’s sarcoma, liposarcoma, malignant fibrous tumors, malignant peripheral nerve sheath tumors, angiosarcoma and chordomas). Management is heterogeneous involving surgery, radiosurgery, radiotherapy, and chemotherapy. While a survival advantage may exist for those given aggressive treatment involving surgical resection, such patients tended to have a favorable preoperative performance status and minimal systemic disease.