Abstract
Metastatic cancer with invasion of skin, soft tissue and skeletal muscle is not common. Examples presenting as soft tissue masses could sometimes lead to misdiagnosis with delayed or inappropriate management. The purpose of current study was to investigate clinical characteristics in the involvement of metastatic cancer. A total of 1,097 patients complaining of skin or soft tissue masses and/or lesions were retrospectively reviewed from January 2012 to June 2013. Tumors involving skin, soft tissue and skeletal muscle of head and neck, chest wall, abdominal wall, pelvic region, back, upper and lower extremities were included in the study. Fifty-seven (5.2%) patients were recognized as having malignancies on histopathological examination. The most common involvement of malignancy was basal cell carcinoma, followed by cutaneous squamous cell carcinoma, sarcoma and melanoma. The most common anatomical location in skin and soft tissue malignancies was head and neck (52.6% of the malignancies). Four (0.36%) of the malignant group were identified as metastatic cancer with the primary cancer source from lung, liver and tonsil and the most common site was upper extremities. One of them unexpectedly expired during the operation of metastatic tumor excision at the scalp. Discrimination between benign and malignant soft tissue tumors is crucial. Performance of imaging study could assist in the differential diagnosis and the pre-operative risk evaluation of metastatic tumors involving skin, soft tissue and skeletal muscle.
Highlights
Metastatic cancer with the invasion of skin, soft tissue and skeletal muscle had been rarely reported before
Among the malignancies involved with skin and soft tissues, the most common was basal cell carcinoma (21 cases, 1.91%), followed by cutaneous squamous cell carcinoma (17 cases, 1.55%), sarcoma (10 cases, 0.91%), melanoma (4 cases, 0.36%), metastatic cancers (4 cases, 0.36%) and cutaneous lymphoma (1 case, 0.09%) (Figure 2)
Our main findings included that prevalence of metastatic tumor invading soft tissues and skeletal muscle was 0.36% in overall skin, soft tissue and skeletal muscle tumors and the most common site of involvement was the upper extremities
Summary
Metastatic cancer with the invasion of skin, soft tissue and skeletal muscle had been rarely reported before It was an extremely rare condition in which metastatic cancer mimicking benign soft tissue masses clinically and could lead to diagnostic confusion for clinicians (Molina-Garrido et al, 2011). It was not infrequent for metastatic cancer presenting as benign soft tissue tumors (Plaza et al, 2008). Soft tissue and skeletal muscle of head and neck, chest wall, abdominal wall, pelvic region, back, upper and lower extremities were included in the study. Performance of imaging study could assist in the differential diagnosis and the pre-operative risk evaluation of metastatic tumors involving skin, soft tissue and skeletal muscle
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