
==== Front
Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.060
vdae090.060
Final Category: Multimodality Approaches
AcademicSubjects/MED00300
AcademicSubjects/MED00310
MMOD-16 THE CHALLENGES IN ASSIGNING THE PRIMARY SOURCE OF METASTATIC FOCUS: PATHOLOGY POINT OF VIEW
Almurshed Maryam Alsabah Hospital, Kuwait, Kuwait

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i19i19
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

Metastasis to the central nervous system is the most common cause of brain lesions, mostly in adults and mostly in the posterior fossa. Assigning the primary source of metastasis in a patient as a first presentation/ unknown primary is challenging to the pathologist. The diagnosis, in pathology point of view depends primarily on three factors: tumour morphology, the immunohistochemical expression, and clinical correlation to definitely specify the primary site of the metastasis. Missing one of thses factors may mislead the final diagnosis. The morphology of the metastasis may differ from the primary site as the metastasis may include “only” the tiny aggressive variant in the primary site, leading to mis- directing the pathological investigation. In addition, the immuno-expression is highly overlapping over different pathological entities, not mentioning the lab quality of stain. In cases of complex tumors, only one component of the tumor can metastasis leading to mis-labelling of the tumor entity. In conclusion, precise pathological diagnosis on tumor metastatic focus as a primary diagnosis can not be achieved without minding these factors, which are essential information to be delivered to the assigning pathologist.
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pmc
