title: CNS Metastases from Bone and Soft Tissue Sarcomas in Children, Adolescents, and Young Adults: Are They Really So Rare?
abstract: Purpose. To check whether primary involvement of brain/spinal cord by bone/soft tissue sarcomas' metastases in children is as rare as described and to present various morphological forms of bone/soft tissue sarcomas' CNS metastases.Methods. Patients with first diagnosis in 1999-2014 treated at single center were included with whole course of disease evaluation. Brain/spinal canal magnetic resonance imaging (MRI)/computed tomography were performed in cases suspicious for CNS metastases. Extension from skull/vertebral column metastases was excluded.Results. 550 patients were included. MRI revealed CNS metastases in 19 patients (incidence 3.45%), 14 boys, aged 5-22 years. There were 12/250 osteosarcoma cases, 2/200 Ewing's sarcoma, 1/50 chondrosarcoma, 3/49 rhabdomyosarcoma (RMS), and 1/1 malignant mesenchymoma. There were 10 single metastases and 7 cases of multiple ones; in 2 RMS cases only leptomeningeal spread in brain and spinal cord was found. Calcified metastases were found in 3 patients and hemorrhagic in 4. In one RMS patient there were numerous solid, cystic, hemorrhagic lesions and leptomeningeal spread.Conclusions. CNS metastases are rare and late in children with bone/soft tissue sarcomas, although in our material more frequent (3.45%) than in other reports (0.7%). Hematogenous spread to brain and hemorrhagic and calcified lesions dominated in osteosarcoma. Ewing sarcoma tended to metastasize to skull bones. Soft tissue sarcomas presented various morphological forms.
authors.affiliation: Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Monika
authors.identifier: 0000-0003-1787-3425
authors.initials: M
authors.lastname: Bekiesinska-Figatowska
authors.affiliation: Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Duczkowska
authors.affiliation: Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Duczkowski
authors.affiliation: Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Bragoszewska
authors.affiliation: Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Romaniuk-Doroszewska
authors.affiliation: Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Iwanowska
authors.affiliation: Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Szkudlinska-Pawlak
authors.affiliation: Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Madzik
authors.affiliation: Clinic of Oncological Surgery of Children and Adolescents, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Bilska
authors.affiliation: Clinic of Oncological Surgery of Children and Adolescents, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Raciborska
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000473:pathology*; D016543:Central Nervous System Neoplasms / Q000556:secondary*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D012983:Soft Tissue Neoplasms / Q000473:pathology*; D055815:Young Adult