title: Skeletal muscle metastases: primary tumours, prevalence, and radiological features.
abstract: BACKGROUND
  Although skeletal muscles comprise nearly 50% of the total human body mass and are well vascularised, metastases in the musculature are rare. The reported prevalence of skeletal muscle metastases from post-mortem studies of patients with cancer is inconstant and ranges from 0.03 to 17.5%.
  
  
  METHODS
  Of 5,170 patients with metastasised cancer examined and treated at our institution during the period from January 2000 to December 2007, 61 patients with muscle metastases (80 lesions) were identified on computed tomography (CT). Genital tumours (24.6%) were the most frequent malignancies metastasising into the skeletal musculature, followed by gastrointestinal tumours (21.3%), urological tumours (16.4%), and malignant melanoma (13.1%). Other primary malignancies were rarer, including bronchial carcinoma (8.2%), thyroid gland carcinoma (4.9%), and breast carcinoma (3.3%). In 8.2%, carcinoma of unknown primary was diagnosed.
  
  
  RESULTS
  Skeletal muscle metastases (SMM) were located in the iliopsoas muscle (27.5%), paravertebral muscles (25%), gluteal muscles (16.3%), lower extremity muscles (12.5%), abdominal wall muscles (10%), thoracic wall muscles (5%), and upper extremity muscles (3.8%). Most (76.3%) of the 80 SMM were diagnosed incidentally during routine staging CT examinations, while 23.7% were symptomatic.
  
  
  CONCLUSIONS
  Radiologically, SMM presented with five different types of lesions: focal intramuscular masses (type I, 52.5% of SMM), abscess-like intramuscular lesions (type II, 32.5%), diffuse metastatic muscle infiltration (type III, 8.8%), multifocal intramuscular calcification (type IV, 3.7%) and intramuscular bleeding (type V, 2.5%).
authors.affiliation: Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany. alex.surow@medizin.uni-halle.de
authors.forename: Alexey
authors.initials: A
authors.lastname: Surov
authors.forename: Michael
authors.initials: M
authors.lastname: Hainz
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Holzhausen
authors.forename: Dirk
authors.initials: D
authors.lastname: Arnold
authors.forename: Michaela
authors.initials: M
authors.lastname: Katzer
authors.forename: Joerg
authors.initials: J
authors.lastname: Schmidt
authors.forename: Rolf Peter
authors.initials: RP
authors.lastname: Spielmann
authors.forename: Curd
authors.initials: C
authors.lastname: Behrmann
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000556:secondary; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
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