title: Rotator cuff metastases: a report of two cases with literature review.
abstract: BACKGROUND
  Distant metastases of primary malignancies to the skeletal muscle tissue are a very rare event. Distant metastases that affect the rotator cuff are even rarer, and only a few of cases have been reported so far.
  
  
  METHODS
  The present article reports two cases that presented to our hospital with the complaint of shoulder pain and had a soft tissue mass affecting the muscles of the rotator cuff and invading the neighboring bone compartments. One of the patients developed mucoepidermoid cancer metastasis of the submandibular gland, and the other was found to have a malignant epithelial tumor metastasized from the lower lobe of the right lung, whose primary origin could not be diagnosed until the imaging examinations were employed. Ultrasound and magnetic resonance imaging findings are presented in this paper.
  
  
  CONCLUSIONS
  Metastases to the muscle tissues could be misdiagnosed as primary sarcomas. Because the therapy regiments and prognoses are fairly different for these two entities, the possibility of a metastasis to the muscle tissue must be considered as a differential diagnosis for case of painful soft tissue mass. Ultrasound is very useful in detection of the lesion and acts as a very important tool during guidance for biopsy. Magnetic resonance imaging, however, is a very valuable asset in the evaluation of the borders of the soft tissue mass and its invasive effect on the bony tissues. Particularly when the features such as lobulated contours, peripheral edema, and intratumoral necrosis exist, the possibility of metastases must be considered.
authors.affiliation: Department of Radiology, Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Soker
authors.affiliation: Department of Physical Therapy and Rehabilitation, Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Eda
authors.initials: E
authors.lastname: Soker
authors.affiliation: Department of Radiology, Faculty of Medicine, Namik Kemal University, Tekirdağ, Turkey.
authors.forename: Bozkurt
authors.initials: B
authors.lastname: Gulek
authors.affiliation: Department of Pathology, Faculty of Medicine, Cukurova University, Adana, Turkey.
authors.forename: Arbil
authors.initials: A
authors.lastname: Acikalin
authors.affiliation: Department of Pathology, Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Elife
authors.initials: E
authors.lastname: Asut
authors.affiliation: Department of Radiology, Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Kaya
authors.affiliation: Department of Radiology, Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Dilek
authors.affiliation: Department of Radiology, Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Yilmaz
keywords: Imaging; Metastasis; Rotator cuff