Indian Journal of Pathology and Microbiology

LETTER TO EDITOR
Year
: 2015  |  Volume : 58  |  Issue : 2  |  Page : 264--265

Central nervous system metastases and immunohistochemistry


Rashmi Patnayak1, Amitabh Jena2, Bodapati Chandra Moliswara Prasad3,  
1 Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
2 Department of Surgical ­Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
3 Department of Neurosurgery, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India

Correspondence Address:
Dr. Rashmi Patnayak
Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati - 517 507, Andhra Pradesh
India




How to cite this article:
Patnayak R, Jena A, Prasad BM. Central nervous system metastases and immunohistochemistry.Indian J Pathol Microbiol 2015;58:264-265


How to cite this URL:
Patnayak R, Jena A, Prasad BM. Central nervous system metastases and immunohistochemistry. Indian J Pathol Microbiol [serial online] 2015 [cited 2020 Aug 5 ];58:264-265
Available from: http://www.ijpmonline.org/text.asp?2015/58/2/264/155360


Full Text

Editor,

We read the article by Sharma et al. "Evaluation of central nervous system metastases with immunohistochemistry correlation" with interest. [1] In this regard we would like to share our experience from a tertiary care center. We had encounered 40 central nervous system metastatic tumors in our study period. Most common primary was lung in our study as reported by the authors. There were 10 cerebellar metastatic adenocarcinomas unlike that reported in literature. With our limited available immunohistochemical panels, we were not able to detect primary in 12 cases. In these cases the routine chest X-ray did not detect any abnormality. [2] There were a couple of cases of metastatic melanoma in our study group unlike the authors. We had a single case of metastatic carcinoma of breast this we attribute to the fact that in developing countries females with advanced malignancy rarely come forward for treatment.

We are of the opinion that a thorough history, good morphological assessment, relevant investigations and judicious use of immunohistochemistry can help to detect the primary tumor. In Indian subcontinent delayed presentation of the patients, poor financial condition and lack of follow-up are major obstacles in detecting the primary tumor, establishing diagnosis as well as in rendering treatment.

As rightly pointed out by Saha, a long-term follow-up study with survival analysis and assessment of Karnofsky performance status should be carried out to predict prognosis and to select appropriate therapeutic protocol. [3]

References

1Sharma P, Trivedi P, Shah MJ. Evaluation of central nervous system metastases with immunohistochemistry correlation. Indian J Pathol Microbiol 2014;57:376-9.
2Patnayak R, Jena A, Vijaylaxmi B, Lakshmi AY, Prasad B, Chowhan AK, et al. Metastasis in central nervous system: Clinicopathological study with review of literature in a tertiary care center in South India. South Asian J Cancer 2013;2:245-9.
3Saha K. Through the microscope: The correct diagnosis to decide a suitable therapy. South Asian J Cancer 2013;2:243-4.