Intracerebral metastases historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Intracerebral metastases was first described by Posner and Chernik, following the largest and most comprehensive autopsy series at the Memorial Sloan-Kettering Cancer Center from 1970 to 1976.^[1]

• Intracerebral metastases was first described by Posner and Chernik, following the largest and most comprehensive autopsy series at the Memorial Sloan-Kettering Cancer Center from 1970 to 1976.^[1]
• More than a century ago, Stephen Paget advanced his “seed and soil” hypothesis, which suggests that the occurrence of intracerebral metastases is not random, but is secondary to certain tumor cells—“the seed”—having an attraction for the surrounding environment—“the soil”. The hypothesis envisages three principles: first, that the neoplasms are composed of heterogeneous subpopulations of cells, with different characteristics; second, that only a selectively “fit” subpopulation of cells will survive and multiply, invade, and migrate to other locations; and finally, that the colonization depends on tumor cell “seed” and host microenvironment “soil” interactions.^[2]
• According to Ewing, the circulatory patterns are responsible for the organ-specific spread between the primary tumor and their final destination.^[2]

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