Magnetic resonance imaging appearance of soft-tissue metastases: our experience at an orthopedic oncology center.
OBJECTIVE
To assess the prevalence and magnetic resonance imaging appearance of metastasis presenting as a soft-tissue mass.


METHODS
A retrospective chart review was performed on 51 patients who presented to an orthopedic oncology center with soft-tissue masses, with a histology-proven diagnosis of soft-tissue metastasis, over a 14-year period. Their magnetic resonance imaging, primary origin, and follow-up have been assessed.


RESULTS
Soft-tissue metastasis was identified in patients ranging from 18 to 85 years old. Most (80%) of the masses were located deep to the deep fascia. In our cohort of patients, melanoma was the most common primary malignancy contributing to soft-tissue metastasis (21.8%). Among soft-tissue metastasis from solid organs, breast and lung were the most frequent (9.1% each). Five patients had soft-tissue metastases from an unknown primary.


CONCLUSIONS
Imaging diagnosis of soft-tissue metastases is challenging as it can demonstrate imaging appearances similar to primary soft-tissue sarcoma. The presence of a known malignancy may not be evident in everyone, and even if available, histopathology will be necessary for diagnosis if this is the only site of recurrence/metastasis to differentiate from a primary soft-tissue sarcoma. Moreover, soft-tissue metastasis may be the initial presentation of a malignancy. Primary malignancies with soft-tissue metastasis carry a poor prognosis; hence, prompt diagnosis and management in essential.
Division of Musculoskeletal Imaging, Joint Department of Medical Imaging, Mount Sinai Hospital and University of Toronto, 600 University Avenue, Toronto, Ontario, Canada, M5G 1X5.
Jennifer
J
Sammon
Division of Musculoskeletal Imaging, Joint Department of Medical Imaging, Mount Sinai Hospital and University of Toronto, 600 University Avenue, Toronto, Ontario, Canada, M5G 1X5.
Abhishek
A
Jain
Division of Musculoskeletal Imaging, Joint Department of Medical Imaging, Mount Sinai Hospital and University of Toronto, 600 University Avenue, Toronto, Ontario, Canada, M5G 1X5.
Robert
R
Bleakney
Division of Musculoskeletal Imaging, Joint Department of Medical Imaging, Mount Sinai Hospital and University of Toronto, 600 University Avenue, Toronto, Ontario, Canada, M5G 1X5. rakesh.mohankumar@uhn.ca.
Rakesh
R
Mohankumar
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000556:secondary*; D055815:Young Adult
Sarcoma; Soft-tissue metastases; Soft-tissue tumor