Skeletal Muscle Metastasis Research Articles

An unusual case of solitary metachronous calf metastasis from gastric carcinoma after curative surgery

Gastric carcinoma is the fifth most common cancer worldwide and a significant cause of cancer-related mortality. It commonly metastasizes to the liver, peritoneum, lungs, and bones. We highlight a rare case with solitary metachronous metastasis to the soleus muscle. A 70-year-old man was evaluated for complaints of dysphagia and diagnosed with locally advanced gastric carcinoma. He underwent radical gastrectomy followed by adjuvant chemotherapy and remained disease free for 2.5 years. Subsequently, he developed a painless swelling in the right calf. Radiological and functional imaging showed an intramuscular lesion within the right soleus muscle with no evidence of disease elsewhere. Histopathological examination of the swelling revealed metastatic adenocarcinoma, consistent with gastric primary. He was started on palliative chemotherapy. Solitary skeletal muscle metastasis with a well-controlled primary is challenging to diagnose and requires histopathology and immunohistochemistry to differentiate it from other soft-tissue neoplasms. The prognosis is poor and the intent of treatment remains palliative.

An Unusual Presentation of Carcinoma Urinary Bladder with Multiple Skeletal Muscle Metastasis

ABSTRACT Lymph nodes, bones, lungs, liver, and the peritoneum are common sites for bladder cancer metastasis. Skeletal muscle involvement is rare. We report the case of a 55-year-old male who has a poorly differentiated carcinoma of the urinary bladder with multiple skeletal muscle metastases.

Uncommon muscle metastatic sites of renal cell carcinoma

Introduction. Renal cell carcinoma (RCC) is the most common malignant renal tumor. It has a tendency for spreading to unusual and distant sites, such as the orbit, paranasal sinuses, thyroid gland, heart, skin, and muscles. Skeletal muscle metastases are accounting for only 0.4% of all metastatic localizations. Following CT, they may be presented in five different radiology types of lesions. The aim of our case was CT evaluation of rare skeletal muscle metastatic localizations of RCC, following the time interval of their occurrence in relation to the appearance of the primary tumor, with emphasis on metastases in the levator ani muscle, since this metastatic localization of RCC has not been recorded in the previous literature. Case outline. We present a 66-year-old man after partial nephrectomy, due to a primary diagnosis of RCC. Three years after the initial diagnosis, multiple distant metastases were verified at typical localizations, as well as rare localizations such as muscles, including levator ani. Conclusion. Advanced metastases in uncommon locations are most often accompanied by a poor prognosis, therefore the further algorithm includes monitoring the whole clinical and radiological status. Metastases in the levator ani muscle have been recorded for the first time in this report. Taking into account that this muscle has very important functions, such as supporting and raising the pelvic visceral structures, as well as having control of the flow of urine and defecation, it is of great importance to include this localization in the CT evaluation.

Muscle metastasis revealing an adenocarcinoma of the lung

Lung cancers are diagnosed at a metastatic stage in 40% to 50% of cases. Skeletal Muscle Metastases (SMM) are rare and usually

Melanoma of unknown primary origin with skeletal muscle metastasis: a case report

BackgroundMelanoma is usually discovered from an irregular skin patch or a modification of a preexisting patch. Cutaneous and lymph node metastases are common. Muscle metastases are rare. We report a case of melanoma with infiltration of the gluteus maximus, which had normal dermatological examination.Case presentationA 43-year-old Malagasy man with no history of skin surgery was admitted with progressively worsening dyspnea. On admission, he presented with superior vena cava syndrome, painless cervical lymphadenopathy, and a painful swelling in the right buttock. Skin and mucous membrane examination did not reveal any abnormal or suspicious lesions. The biology was limited to a C-reactive protein of 40 mg/L, a white blood cell count of 23 G/L, and a lactate dehydrogenase level of 1705 U/L. The computed tomography scan showed several lymphadenopathies, compression of the superior vena cava, and a tissue mass at the expense of the gluteus maximus. Cervical lymph node biopsy and cytopuncture of the gluteus maximus were consistent with a secondary melanoma location. A stage IV melanoma of unknown primary origin, and with stage TxN3M1c associated with lymph node metastases and extension to the right gluteus maximus, was suggested.ConclusionsMelanoma of unknown primary origin accounts for 3% of diagnosed melanomas. Diagnosis is difficult in the absence of a skin lesion. Patients are diagnosed with multiple metastases. Muscle involvement is unusual and may suggest a benign pathology. In this context, biopsy remains essential for diagnosis.

Skeletal muscle metastases in neuroblastoma share common progenitors with primary tumor and biologically resemble stage MS disease.

While subcutaneous metastases are often observed with stage MS neuroblastoma, an entity that usually resolves spontaneously, skeletal muscle metastases (SMM) have been rarely described. The purpose of this retrospective study was to investigate the significance of SMM in neuroblastoma. Seventeen patients with neuroblastoma SMM were diagnosed at a median age of 4.3 (0.1-15.6) months. All had SMM at diagnosis and metastases at other sites. Fifteen (88%) had ≥ 2 SMM in disparate muscle groups. One, 14, and 2 patients had low, intermediate, and high-risk disease respectively. Fifteen tumors had favorable histology without MYCN amplification, and 2 were MYCN-amplified. Most SMM (80%; n=12/15 evaluated) were MIBG-avid. Only 1 patient (with MYCN-non-amplified neuroblastoma) had disease progression. All survive at median follow-up of 47.9 (16.9-318.9) months post-diagnosis. Biological markers (histology, chromosomal and genetic aberrations) were not prognostic. Whole genome sequencing of 3 matched primary and SMM lesions suggested that both primary and metastatic tumors arose from the same progenitor. SMM completely resolved in 10 patients by 12 months post-diagnosis. Of 4 patients managed with watchful observation alone without any cytotoxic therapy, 3 maintain complete remission with SMM resolving by 5, 13, and 21 months post-diagnosis respectively. Children with neuroblastoma SMM have an excellent prognosis, with a clinical course suggestive of stage MS disease. Based on these results, the initial management of infants with non-MYCN-amplified NB with SMM could be watchful observation, which could eliminate or reduce exposure to genotoxic therapy.

Diplopia Secondary to Gastric Adenocarcinoma Metastasis to the Superior Oblique Muscle.

While gastric cancer often metastasizes to the liver, lymph nodes, and lungs, skeletal muscle metastasis is a rare event. The most common primary tumor metastasizing to the extraocular structures is breast cancer. Gastric carcinoma metastatic to the extraocular muscles is a rare event announcing a spreading disease with a bad prognosis. Here, we report a case of an asymptomatic gastric carcinoma metastasizing to the superior oblique muscle diagnosed via an endoscopic endonasal biopsy.

Uncommon disseminated muscular metastasis from suspected lung adenocarcinoma in a 18F-FDG PET/CT study

Skeletal muscle metastasis from lung cancer is a rare phenomenon. In this case report, FDG PET/CT imaging detected unexpected metastatic spread in skeletal muscles from lung cancer.

Skeletal muscle metastasis from colorectal adenocarcinoma: A literature review.

BACKGROUNDColorectal adenocarcinoma is the third most common cancer worldwide. It accounts for almost 10% of all cancer-related deaths. Skeletal muscle is a very unusual site for metastasis from colorectal cancers and is associated with a poor prognosis and high mortality.AIMTo review the literature for cases of skeletal muscle metastasis (SMM) from colorectal adenocarcinoma.METHODSA systematic literature search using a validated search strategy was carried out to identify the incidence of SMM associated with colorectal adenocarcinoma. The studies identified were tabulated in a PRISMA, and data was extracted in a tabulated form.RESULTSTwenty-nine studies were included in this literature review. SMM was most commonly detected in the thigh muscles. Most of the tumours had originated from the rectum or the right colon. The histopathology of the primary tumour was generally advanced. The mean time interval between the primary tumour and onset of SMM was 22 mo. In 3 cases, asymptomatic SMM had been picked up by advanced imaging systems, like fluorodeoxyglucose-positron emission tomography scan.CONCLUSIONSMM from colorectal adenocarcinomas is a rare complication. However, it is possible that the low incidence could be due to under-reporting. Early use of advanced imaging techniques and a high index of clinical suspicion might increase the reporting of SMM from colorectal adenocarcinoma.

Skeletal Muscle Metastasis From Renal Cell Carcinoma: A Case Series and Literature Review

ObjectivesSkeletal muscle metastasis (SMM) from renal cell carcinoma (RCC) has been rarely reported. This case series was performed to increase the clinicians' understanding of its clinical features and treatments.MethodsWe evaluated the clinical presentations, diagnoses, and treatments of 2 patients with SMM from RCC in our hospital and 39 cases reported in the literature.ResultsAmong the 41 patients, 4 (9.76%) were women and 37 (90.24%) were all men. The average age was 60.5 ± 12.6 years old (range from 7 to 81). The size of tumors varied from 1 to 28 cm, and the metastatic sites of 6 (14.63%) cases were in the heads, 20 (48.78%) in the limbs, 9 (21.95%) in the trunks, 3 (7.32%) in the buttock, and the other 3 (7.32%) were multiple sites. The mean of intervals between the RCC and the discovery of the first SMM was 73.61 months. More than half of the patients (25, 60.98%) were diagnosed by MRI and 25 (60.98%) patients performed a biopsy of the mass to establish the diagnosis. Finally, 30 (73.17%) cases performed mass excision. Then the adjuvant therapy was performed in 18 patients including immunotherapy, radiotherapy, chemotherapy, and targeted therapy. The median follow-up after SMM was 9 months (P25, P75: 5, 23), in which the longest survival time of patients with SMM of RCC was 8 years while the shortest was only 3 months.ConclusionThe characteristic clinical feature of SMM from RCC is asymptomatic masses or swelling with a long history which can be preoperative suspiciously diagnosed by MRI. The rapid biopsy of suspected lesions, determination of other metastasis sites, resection of metastasis, and systematic treatment are the recommended treatments of it.

Skeletal muscle metastases: pitfalls and challenges of a highly inhospitable environment.

Skeletal muscle metastases: pitfalls and challenges of a highly inhospitable environment.

Hypopharyngeal carcinoma with skeletal muscle metastases: a rare clinical entity

The common sites of distant metastatic spread of head and neck malignant tumor are lungs, liver, and bones. Skeletal muscles metastases are extremely rare. We present a case of 61-year-old man who was previously treated with radical chemo radiotherapy for hypopharyngeal squamous cell carcinoma, stage T4bN2cM0. During surveillance follow up 21 months post treatment, he developed a right proximal arm mass. There were no neurological or vascular deficit. MRI revealed an irregular enhancing intramuscular soft tissue mass within the right triceps muscle, with widespread nodal and skeletal muscle metastases. Tissue biopsy revealed a metastatic carcinoma favoring poorly differentiated squamous cell carcinoma. He received palliative chemotherapy but died 4 months later. Skeletal muscle metastases must be high in the list of differential diagnosis in a head and neck cancer patient presented with a muscle mass, even though it is rather rare. Radiological imaging and tissue biopsy helped in the diagnosis and prompt management.

A case of Mazabraud syndrome that required distinction from bone and skeletal muscle metastasis

A case of Mazabraud syndrome that required distinction from bone and skeletal muscle metastasis

Hepatocellular carcinoma with uncommon sites of metastasis: a rare case report

BackgroundHepatocellular carcinoma (HCC) is a highly malignant tumor, causing both intrahepatic and extrahepatic metastases. The extrahepatic metastasis occurs in one-third of patients with HCC and it is associated with a poor prognosis. The most common sites of extrahepatic metastasis are lung, regional lymph nodes, bone, adrenal glands, and peritoneum/omentum. Detection of such extrahepatic metastasis plays a vital role in the staging and treatment planning of HCC.Case presentationA 60-year-old man was presented to our centre with loss of apetite, generalised weakness, and weight loss. Abdominal examination revealed a firm lump in the right hypochondrium. CT findings revealed a large well-defined hypodense mass in almost entire right lobe of the liver. A well-defined oval, heterogeneously enhancing soft tissue mass lesions were also noted in both adrenal glands and psoas muscles. For histopathological diagnosis, percutaneous ultrasound-guided truecut biopsy was done from right lobe liver mass confirming well differentiated HCC.ConclusionsIn the present case report, we present an extremely rare and unique case of HCC with disseminated skeletal muscle metastasis with concomitant bilateral axillary lymph node metastasis. It is crucial for radiologists to detect such extrahepatic sites of metastasis initially at the time of diagnosis for accurate staging and treatment planning for a better prognosis.

Non-small Cell Lung Cancer as Skeletal Muscle Metastasis.

Non-small Cell Lung Cancer as Skeletal Muscle Metastasis.

Cervical Skeletal Muscle Metastasis of Colorectal Cancer.

Cervical Skeletal Muscle Metastasis of Colorectal Cancer.

Malignant Phyllodes Breast Tumor: A Rare Case of Metastasis in Skeletal Muscle Detected on 18-Fluorodeoxyglucose Positron Emission Tomography

Rapidly growing cystosarcoma phyllodes tumor (PT) of the breast are rarely encountered. Distant metastases are not uncommon in malignant PTs; however, rare sites of metastases are sometimes observed. Here, we present the case of a rapidly metastasizing malignant PT in which skeletal muscle metastasis was identified on 18F-fluorodeoxyglucose-based positron emission tomography-computed tomography reflecting its aggressive course and poor prognosis.

338 Biceps Metastasis Presenting as A Presumed Abscess in Patient with An Undiagnosed Non-Small Cell Lung Cancer - An Unusual Presentation

Abstract Lung cancer is the most common cancer worldwide and has highest cancer mortality. Around 50% of cases present with metastasis, however skeletal muscle metastasis is rarely reported. In this case we describe a fifty-nine-year-old male patient who presented complaining of fever and a mass on the distal biceps and proximal forearm over a five-month period, with no reported improvement despite debridement and antibiotics spanning three presentations to the emergency department. Subsequent biopsy at various anatomical sites showed adenocarcinoma, later identified as metastatic from a primary non squamous-cell lung cancer (NSCLC). Metastases from lung cancer are more commonly limited to liver and adrenal glands. Presentation of such a mass in skeletal muscle would raise suspicion for the more-commonly seen soft-tissue sarcoma or hemangiomas. This case illustrates a rare example of lung cancer metastatic to skeletal muscle, more specifically, the biceps. Presentation of the mass was also unique in its morphology of an abscess with purulent discharge, raising the importance of cytology and suspicion for malignancy in an abscess unresponsive to antibiotics. Non-small cell lung cancer can present with skeletal metastasis. A work-up of a mass or abscess of the muscle should include the possibility of soft tissue metastasis.

Isolated brachioradialis metastasis of gastric adenocarcinoma after R0 resection

BackgroundGastric cancer is the fifth most common cancer worldwide, with an incidence of 6.72 per 100,000 people. Thirty-two percent of gastric cancer patients will live 5 years after diagnosis. Single-site metastasis is noted in 26% of patients with gastric cancer, most commonly in the liver (48%), peritoneum (32%), lung (15%), and bone (12%). Here, a case is presented in which a single skeletal muscle metastasis appeared after appropriate resection and treatment.Case presentationA 63-year-old man underwent neoadjuvant chemotherapy and a multivisceral en bloc R0 resection. Final pathology showed no evidence of lymph node metastasis with 31 negative lymph nodes. Four months postoperatively, the patient was found to have a rapidly growing biopsy-proven extremity soft tissue gastric metastasis within the brachioradialis muscle. He subsequently underwent metastasectomy and immunotherapy.ConclusionThis case is a rare example of an isolated extremity metastasis of gastric adenocarcinoma in the setting of an R0 resection of the primary tumor and negative nodal disease on final pathology, suggestive of hematogenous spread. We review the biology, workup, and management of gastric cancer and highlight new advancements in the treatment of this aggressive cancer.

Case Report of Denovo Musculoskeletal Metastasis from Hormonal Positive and Her2 Negative Receiving CDK4 Inhibitor

Skeletal muscle metastasis from breast cancer is a very rare presentation. We reported a case with breast cancer metastatic to skeletal muscle, bone, peritoneum and lymph node at presentation detected in FDG PET-CT. A Core needle biopsy was performed from the left breast tail lesion. Immunohistochemistry showed hormonal positivity, Her2 negativity with low KI67. Patient was treated with combined CDK4 inhibitor and non-steroidal aromatase inhibitors with regressive course in the PET-CT after the 1st 3 months. More studies should investigate the prognosis and proper management of skeletal muscle metastasis in breast cancer.