Controversy of Surgical Intervention for Brain Metastases: Series of 27 Patients

Abstract Background: The prevalence of brain metastases (BM) sur-passes that of other intracranial neoplasms in adults. Surgical intervention for the management of brain metastases has led to considerable controversy. Patients exhibiting specific clin-ical characteristics may potentially achieve extended survival rates when undergoing resection as opposed to radiation thera-py. Therefore, in the context of well-controlled systemic cancer, surgical intervention is strongly recommended for patients who have a single metastatic lesion. The combination of positron emission tomography and computed tomography (PET/CT) is a frequently utilized imaging technique in the field of oncology. It offers a distinct blend of cross-sectional anatomical data from CT and metabolic information from PET scans. Aim of Study: To determine the efficacy of surgical excision of a single metastatic lesion and the diagnostic performance of brain-included whole-body PET/CT in the identification and assessment of brain metastases, this retrospective study was conducted. Patients and Methods: The study was conducted over a period of 24 months on 27 patients having extra-cranial malig-nancies with single brain metastases with preoperative brain-in-cluded whole-body PET/CT. Results: Male were predominant (3:1), and bronchogen-ic carcinoma was the most frequently primary malignancy. Headache, fits, heaviness, and vomiting were the most obvious symptoms. Out of the total of 27 patients, 18 (67%) had brain metastases of unknown origin, whereas 9 (33%) had brain me-tastases from recognized source tumors. Following a compre-hensive FDG-PET/CT scan that covered the brain, it was deter-mined that 12 patients (44.4%) had bronchogenic carcinoma, 3 patients (11%) had renal cell carcinoma, and 3 patients (11%) had breast cancer. Conclusions: Surgery is a highly successful option for managing tumors, especially in situations of single brain me-tastasis. It is a crucial component of the treatment plan for brain metastases. Whole-body FDG-PET/CT, including the brain, offers significant additional information for assessing patients who are suspected to have brain metastases (BM).