The single supratentorial lesion. An evaluation of preoperative diagnostic tests

R. M. Voorhies, N. Sundaresan, H. T. Thaler

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45 Scopus citations


The role of preoperative diagnostic tests was evaluated in 210 adult patients with single supratentorial lesions demonstrated by computerized tomography. At craniotomy, 59.5% of these patients proved to have primary brain tumors, 36.2% had metastatic tumors, and 4.3% had non-neoplastic lesions. In 23 (11%) of these patients, a single brain metastasis was the first manifestation of a systemic cancer. The primary site of cancer was identified in 14 patients (10 in the lung, 3 in the kidney, and 1 in the colon), and in 9 patients the primary site could not be established. Using simple conditional probability theory, the authors established that the probability of a metastatic lesion in patients without a history of previously treated cancer is about 7%, if their chest X-ray film and intravenous pyelogram (IVP) are negative. Extensive preoperative testing to try to establish a primary site is unrewarding if the chest X-ray film and IVP are negative, since these are the only sites likely to be identified in these patients. In patients with a history of previously treated cancer, these tests are justified because they have prognostic value in determining treatment.

Original languageEnglish
Pages (from-to)364-368
Number of pages5
JournalJournal of Neurosurgery
Issue number3
StatePublished - 1980
Externally publishedYes


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