The incidence of brain metastases in sarcoma patients, particularly those with rhabdomyosarcoma and malignant fibrous histiocytoma, is higher than previously recognized, suggesting a potential need for preventive CNS treatments.
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May not yet alter sarcoma surveillance; leaves open whether CNS screening benefits high-risk subtypes.
Eleven cases of brain metastases that developed in 114 sarcoma patients are presented. Two of 11 patients presented with brain metastasis at the time of diagnosis and the other nine developed them later. The high incidence of brain metastases in patients with rhabdomyosarcoma (26%) and malignant fibrous histiocytoma (27%), two types of tumor which supposedly metastasize rarely to the brain, is remarkable. The increased incidence of brain metastases may be related to longer survival of sarcoma patients and to the inability of AMN and other drugs used in the treatment of sarcomas to cross the blood-brain barrier. Preventive treatment of brain metastases with drugs active in the CNS or with radiotherapy following the diagnosis of pulmonary metastases, could be useful, especially in patients with rhabdomyosarcoma and malignant fibrous histiocytoma.
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España et al. (1980) studied this question.
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