Unsuspected metastases presenting as solitary soft tissue lesions: a fourteen-year review.
OBJECTIVE
To describe a series of patients with no known primary malignancy who presented with a solitary unsuspected soft tissue metastasis masquerading as a soft tissue sarcoma, and secondarily to describe the imaging appearance of these lesions.


METHODS
Records of two academic hospitals with active orthopedic oncology services were reviewed for patients meeting the above criteria. Clinical charts were examined, and the imaging appearance of the soft tissue lesions retrospectively reviewed.


METHODS
Of 1421 patients examined for soft tissue lesions, 11 were found who met the above criteria.


RESULTS
Of the 11 patients whose initial presentation was a solitary soft tissue metastasis, eight were found to have a primary lung cancer, two were diagnosed with adenocarcinoma of unknown primary, and adenocarcinoma of the colon was discovered in the remaining patient.


CONCLUSIONS
The clinical presentation of a solitary soft tissue metastasis without a known primary malignancy is a rare occurrence, with an incidence of approximately 0.8%. Lung cancer is the primary neoplasm in a high percentage of these cases.
Glockner
J F
JF
Department of Radiology, St. Louis University Hospital, MO 63110-0250, USA.
White
L M
LM
Sundaram
M
M
McDonald
D J
DJ
D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018196:Carcinoma, Adenosquamous / Q000175:diagnosis / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary; D003110:Colonic Neoplasms / Q000175:diagnosis; D003287:Contrast Media; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000175:diagnosis / Q000556:secondary; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis*; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000556:secondary*; D014057:Tomography, X-Ray Computed
D003287:Contrast Media