In 1940, Batson (6) ushered in a new era with the theory that metastasis occurs through the vertebral veins. It was based on the premises that metastatic tumors may show typical and peculiar distributions, that such patterns have not been adequately explained by orthodox theories, and that cadaver and animal injection experiments reveal the existence of a network of vertebral veins whose vast interconnections explain the puzzling patterns seen in metastases. Undoubtedly, Batson’s theory has been widely acclaimed. However, several criticisms are on record. The prevailing controversy needs to be resolved. The prospects are that this can be achieved by further research in this important field.

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