Metastasis of lung cancer through Batson’s plexus: very rare but possible

Abstract

Many malignancies, like prostate, colon, and breast cancer, metastasize throughBatson’s plexus (vertebral venous plexus). Although lung cancer is one of the mostcommon cancers in the United States, its spread through Batson’s plexus is consideredextremely rare. We report a 76-year-old woman with adenocarcinoma of the lung whohad metastasis affecting multiple contiguous vertebral bodies likely due to disseminationthrough Batson’s plexus of veins. This plexus is a component of the cerebrospinalvenous system (CSVS) consisting of the cranial venous system and the vertebralvenous plexus (Batson’s plexus). The CSVS is a valveless network of veins which areimportant in the venous drainage of the brain and spine. However, this venous networkprovides an easy channel for the dissemination of infections and malignant cells.

Osteosarcoma with Orbital Metastasis in a Nigerian Child: A Case Report and Review of the Literature

“…[15,17,18,32] Nonpulmonary metastasis of osteosarcoma has been postulated to occur possibly through Batson's paravertebral system. [14] Surprisingly, to the best of these researchers' knowledge, contralateral left orbit metastasis secondary to right lower limb osteosarcoma, as observed in the index case, is not known in the literature. [15][16][17][18]32] Baston's plexus are valveless venous systems with bi-directional blood flow which perhaps may account for haematogenous metastasis to any orbit irrespective of the primary side.…”

“…[15][16][17][18]32] Baston's plexus are valveless venous systems with bi-directional blood flow which perhaps may account for haematogenous metastasis to any orbit irrespective of the primary side. [14] Chemotherapy as a neo-adjuvant to surgery is effective. This therapy was commenced in the index case and she was scheduled for surgery after twelve weeks of chemotherapy.…”

“…With orbital metastasis, the absence of pulmonary metastasis occurs and this is due to the haematogenous spread of the disease through Batson's venous plexus. [14] The commonest primary disease site of previously reported cases is the tibia while the scapular was observed as a primary site in a case. [15][16][17][18] With careful search, there has been no previous report on orbital metastasis of osteosarcoma in Nigeria.…”

Model-based inference of metastatic seeding rates in de novo metastatic breast cancer reveals the impact of secondary seeding and molecular subtype

“…Posterior intercostal veins drain initially into the azygous vein which communicates with valveless system of veins located in the epidural space called Batson’s vertebral venous plexus 18 . It regulates intracranial pressure with posture and drains the cerebral, abdominal and pelvic cavities 19 . Due to the lack of valves, an increased pressure in the vena cava system can result in backward flow of venous blood from the breast 20 , proposing a possible pathway for metastatic spread via Batson’s vertebral venous plexus to the vertebrae, skull, pelvis bone and the central nervous system.…”

“…Experiments on mice have shown that under pathological conditions, such as increased abdominal pressure, tumor cells can spread to the brain via the venous system 19 . This supports the hypothesis that Batson’s venous plexus serves as a venous channel connecting the cerebral, abdominal, and pelvic cavities.…”