Clinical and therapeutic insights into intraventricular metastases from extracranial solid tumors: Patterns, prognosis and management

Solid intraventricular metastasis from extracranial primary tumors (SIMs) are rare and their diagnosis and management remain poorly understood. A systematic review was conducted using the MEDLINE and Embase databases to identify relevant studies published until November 2024. Data such as presenting symptoms, treatments and survival outcomes were extracted from included articles on patients with SIMs. A total of 26 studies, involving 26 patients (34.6% female patients; median age, 64 years), met the inclusion criteria. The most common primary tumor was renal cell carcinoma (38.5%). Furthermore, 57.7% of patients had metastasis to one or both lateral ventricles, 19.2% had metastasis to the lateral and fourth ventricle, 11.5% had metastasis to the third ventricle alone, 7.7% had metastasis to the lateral and third ventricle, and 3.8% had metastasis to the fourth ventricle alone. Treatment approaches varied, with tumor resection (42.3%) being the most common intervention, followed by tumor resection with adjuvant chemo/radiation therapy (15.4%). The median post-treatment survival time was 4.3 months. Patients receiving tumor resection combined with radiation or chemotherapy had the longest survival (median, 24 months), compared with those undergoing tumor resection alone (median, 2 months). SIMs are rare but clinically significant, with variable treatment approaches and survival outcomes. Multimodal therapy offers the best prognosis, although survival remains generally poor. Further research is needed to better understand the pathophysiology, treatment strategies and outcomes of SIMs.