Metastases represent the most frequent brain neoplastic lesions in the adult population. Calcified brain metastases (CBM) are reported to be rare and to be found predominantly in patients treated with radiotherapy (RT). Nevertheless CBM may be present ab initio and must be differentiated from other calcified lesions. The primary tumors reported to be responsible for CBM are squamous cell carcinoma of the lung, adenocarcinoma of the lung, breast adenocarcinoma, sarcoma of the mediastinum, squamous cell carcinoma of the cervix, adenocarcinoma of the pancreas, non-Hodgkin’s lymphoma,...

A series of 1000 consecutive brain CT scans of patients with known primary tumors was retrospectively assessed, and the presence of brain metastases was reported. Among 182 patients with brain metastasis we searched for the presence of calcification within the lesions. Only intra-axial metastases were considered. Two blinded expert neuroradiologists analyzed the CT images, both without and with contrast media. CBM were defined by the presence of calcification within intra-axial enhancing lesions. Also calcifications within lesions with increased volume and contrast enhancement at follow-up scans...

Among 182 patients with evidence of brain metastaseswe found 31 patients with CBM (17%); 16 of the CBM patients underwent radiotherapic treatment (either whole brain or stereotactic radiosurgery) before the appearance of calcification, the remaining 15 patientspresented with calcificationab initio. Therefore 8,2% of all patients with brain metastases showed calcification within at least one metastatic lesion.The majority of patients with CBM had aprimitive lung adenocarcinoma (66,7%), followed bybreast adenocarcinoma (22,6%)and bylung microcytoma (6,5%), while none originated from melanoma and from other less common primary tumors,...

To the best of our knowledge this is the largest reported series of patients with CBM. Deck et al report CBM to be 3,5% of cases (3), while in our series we observed a frequency of 8,2% of CBM ab initio; such higher frequency is likely due to the higher sensitivity of today’s CT scanners. Another 8,8% of CBM were identified after RT. It is known that RT may activate the process of calcification, while the process behind ab initio CBM is not completely clear...

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1.Kawamura D. et al: Slow Progression of Calcified Cerebellar Metastasis From Ovarian Cancer: A Case Report and Review of the Literature. NeurolMed Chir (Tokyo) 53, October, 2013. 2.Graña L et al: Calcified cerebral metastases. Radiology. 2007; 49: 335-7 3.Deck MD et al: Computed tomography in metastatic disease of the brain. Radiology. 1976 Apr; 119 (1): 115-20. 4.Ressl N et al: Multiple calcified brain metastases in a man with invasive ductal breast cancer. MJ Case Reports 2015. 5.Hwang TL et al: Calcified brain metastasis. Neurosurgery32: 451-454;...