By Jerome B. Posner (auth.), Leonard Weiss Sc.D., M.D., Ph.D., Harvey A. Gilbert M.D., Jerome B. Posner M.D. (eds.)
Of these humans death with melanoma, many die because of metastases. nevertheless, an incredibly small variety of texts were dedicated to this clinically very important subject. the current sequence of monographs originated in discussions, which confident us of the necessity for texts on metasasis which might comprise not just simple and scientific observations on humans and the place neces sary, on experimental animals but in addition discussions of the state-of-the-art in prognosis and remedy. to be able to accomplish that in-depth method, for which ebook was once preceded by means of small workshops, it was once essential to impose boundaries at the scope of the subject. Metastasis is consequently dis stubborn by way of website, and the sequence is equipped therefore. the 1st quantity within the sequence, Pulmonary Metastasis, was once an multiplied model of a Workshop held at Roswell Park Memorial Institute in 1977. This, the second one quantity, is predicated on an identical workshop on metastasis to the mind, held on the Memorial Sloan-Kettering melanoma middle in September, 1978. In organiz ing either the workshop and in enhancing this quantity, we've been excep tionally lucky to obtain the beneficiant cooperation of Dr. Jerome B. Posner, a working towards neurologic oncologist who has given freely of his ex pertise during this really expert field.
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The sensitivity of the primary tumor to various treatment modalities also has a major role in determining the clinical approach to the brain metastasis. Classification 12 A CLINICIAN'S VIEW _ _ _ _ _ _ _ _ _ _ _ _ _ __ of brain metastases by the systemic condition of the patient has important therapeutic implications: that is, is the patient otherwise free of systemic disease? All of these forms of classification must be considered for an individual patient because they have significant clinical, therapeutic, and physiologic implications.
Within the skull are the brain, its blood supply, and the cerebrospinal fluid (CSF). The CSF fills the ventricles in the center of the brain and the subarachnoid space over the surface of the brain. An increase in the size of one compartment of the brain can only occur if there is a decrease in the size of one of the other compartments. When new tissue such as a brain metastasis is introduced into the intracranial cavity, the other tissues must accommodate by decreasing their quantity or elevated pressure will shift intracranial structures and compromise the blood supply to the brain.
R. Soc. Med. 28:1080-1096, 1935. ; and Wiernik, P. H. Increasing incidence of brain metastases in sarcoma patients. Prac. ASCO 19:370, 1978. Gercovich, R. ; Luna, M. ; and Gottlieb, J. A. Increased incidence of cerebral metastases in sarcoma patients with prolonged survival from chemotherapy. Report of cases of leiomyosarcoma and chondrosarcoma. Cancer 36:1843-1851, 1975. Gilbert, R. ; Kim, J. ; and Posner, J. B. Epidural spinal cord compression from metastatic tumor: diagnosis and treatment. Ann.