Hemorrhagic intracranial metastases are considered to represent between 3-14% of all cerebral metastases (cf. 1-3% of gliomas are hemorrhagic).
These classically originate from:
- melanoma
- renal cell carcinoma
- choriocarcinoma
- thyroid carcinoma: papillary carcinoma of the thyroid has the highest rate of hemorrhage
- lung carcinoma: given the sheer number of cases, even though atypical for these primaries they are, nonetheless, common
- breast carcinoma: as for lung
- hepatocellular carcinoma
- hepatoblastoma (rare) 6
- osteogenic sarcoma (rare) 7
These can be recalled with the mnemonic MR CT BB.
Differential diagnosis
- primary hemorrhagic brain tumor, e.g. glioblastoma with hemorrhage (in the case of a single metastasis)
- primary lobar hemorrhage
- hemorrhagic transformation of an ischemic infarction
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