1984 Volume 75 Issue 2 Pages 278-282
Out of 112 patients with renal cell carcinoma, seen in the Jikei University Hospital during the 11-year period from July 1973 through June 1983, 9 (8.0%) exhibited brain metastasis. The examination of the afflicted side of the primary focus revealed the brain metastasis in 6 of 63 patients (9.5%) in the case of the left renal carcinoma, and in 3 of 48 patients (6.3%) in the case of the right.
There was thus a tendency for the brain metastasis to occur more easily in the left than in the right renal cancer. As for the time of the metastasis discovery, it was already at the time of initial diagnosis in 2 cases, and in the other 7, it was after nephrectomy. The average interval between the operation and metastasis discovery was 3 years, and in 4 of the 7 cases (57%), over 3 years had passed in between. Seven of the 9 cases were complicated by pulmonary metastasis, and it was considered most frequent that the brain metastasis occurred by the route through the pulmonary metastatic focus. As for the symptom of brain metastasis, dyskinesia was most frequent, being seen in 5 cases (56%), followed by headache, nausea, lalopathy, dysopia and dusuria. As for the diagnostic method, CT scanning was most effective, and as for the treatment, 4 of the 9 cases were subjected to operation with the highest efficacy. But radiotherapy and chemotherapy, performed on 4 cases, were without effect. One-year survival rate for the 9 cases was 22%, and the interval between the diagnosis of brain metastasis and death for the 7 dead cases ranged 2 months to 4 years and 6 months, with the mean of 11.4 months. The time of diagnosis and the method of therapy were recognised as the factors influencing the prognosis of brain metastasis.
