Skeletal muscle metastases of carcinoma: a clinicopathological study of 12 cases.
OBJECTIVE
To clarify the clinical and magnetic resonance (MR) imaging features of a rare condition of metastasis of carcinoma to skeletal muscle.


METHODS
Clinicopathological findings for 12 patients (10 male, two female, age range 48-89 years, mean age 68 years) with skeletal muscle metastases of carcinomas were reviewed retrospectively.


RESULTS
In nine of the 12 patients the skeletal muscle metastasis was presented as "painful mass". The lung was found to be the most common primary source, accounting for 33% of the cases, and the lower extremity was the most common metastatic site, accounting for 67% of the current series. Diagnosis was made by biopsy in all cases. Overall, MR images were not specific, but on the gadolinium-DTPA enhanced MR images, extensive peritumoral enhancement associated with central necrosis was found in 11 of the 12 patients (92%). Seven patients died within 2-19 months (average: 9 months) after the detection of the skeletal muscle metastasis, among whom only one patient was continuously disease free for 92 months after wide excision of the metastatic lesion.


CONCLUSIONS
Skeletal muscle metastasis is often presented as a painful mass in patients with known primary carcinoma. For diagnosis, needle biopsy is mandatory. However, a painful mass with an extensive peritumoral enhancement should be highly suspected to represent carcinoma metastasis to skeletal muscles. In selected patients, wide excision with combined chemotherapy could yield unexpectedly good results.
Tuoheti
Yilihamu
Y
Department of Orthopedic Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.
Okada
Kyoji
K
Osanai
Toshihisa
T
Nishida
Jun
J
Ehara
Shigeru
S
Hashimoto
Manabu
M
Itoi
Eiji
E
D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D008175:Lung Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D018482:Muscle, Skeletal / Q000473:pathology*; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D013274:Stomach Neoplasms / Q000473:pathology
D019786:Gadolinium DTPA