Clinical and radiological profiles of metastatic brain tumor in Indonesia: A study at Dr. Soetomo Hospital, Surabaya

Abstract

Background: Brain metastases have increased over time, and imaging has been considered an important diagnostic tool. In Indonesia, the record of metastatic brain tumors is limited. Therefore, understanding the epidemiology and the imaging characteristics of brain metastases will provide insights into a better diagnosis, management, and therapy towards the disease. This study aimed to evaluate the characteristics of patients with metastatic brain tumors. Methods: A cross-sectional study was conducted in Neurology Unit at Dr. Soetomo Hospital in Surabaya, Indonesia from August 2018 - July 2019. Patients with metastatic brain tumors were enrolled in the study. Data demographics, clinical, and brain imaging characteristics were collected from the patients’ Brain Tumor Registry. Computerized tomography (CT) scan and magnetic resonance imaging (MRI) was used to assess the images of the brain metastases. Mini-Mental State Exam (MMSE) was used to assess the patient's cognitive function. Results: Of the total 22 subjects, 14 (63.6%) were male, 13 (59.1%) aged ≥50 years. Headache was the most common clinical symptom, reported by 78.2% of patients. Most of the patients (63.3%) had MMSE score of ≤ 23. CT-scan and MRI imaging suggested that multiple lesions were the most common, 57.8% and 71.4%, respectively. The brain tumor's most frequent was in the parietal and temporal lobes (CT-scan imaging) and temporal and cerebellar lobes based on MRI. Lung tumors were the most common source of brain metastases (50%), followed by breast and nasopharynx cancers (13.6% each); 9% had unknown sources. Conclusions: Our study suggests that the frequency of metastatic brain tumors is gender and age-specific. Headache with early stage of dementia is common among patients with metastatic brain tumor. Multiple lesions in parietal and temporal lobes with lung cancer as the source are common.