Abstract
The MRI revealed well-demarcated solid masses in the left gluteal muscles and the right piriformis muscle showing significant contrast enhancement. Both sciatic nerves were surrounded by the tumor masses, their fibers being thickened with no enhancement with contrast medium (black arrows in Fig.1 in ‘‘Question”). Multicentric intramuscular mass lesions suggest metastasis, leukemia, lymphoma, and sarcoidosis. When patients have a history of cancer, metastasis is supported by clinical and radiological findings. The diagnosis was confirmed via needle biopsy. Although skeletal muscles comprise nearly 50% of the total body mass and have a profuse blood supply, metastatic involvement is quite rare, which is unexplained. It may be related to contractile activity, high tissue pressure, the accumulation of lactic acid, local changes in pH, or oxygenation. The frequency of muscle metastases is reported as 0.8% to 16% in necropsy studies, lung carcinomas being the most usual source. The most commonly involved muscles
Published Version
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