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Japanese Journal of Clinical Oncology 34:210-214 (2004)
© 2004 Foundation for Promotion of Cancer Research

Skeletal Muscle Metastases of Carcinoma: a Clinicopathological Study of 12 cases

Yilihamu Tuoheti1, Kyoji Okada1, Toshihisa Osanai3, Jun Nishida4, Shigeru Ehara5, Manabu Hashimoto2 and Eiji Itoi1,+

Departments of 1 Orthopedic Surgery and 2 Radiology, Akita University School of Medicine, Akita, 3 Department of Orthopedic Surgery, Yamagata University School of Medicine, Yamagata and Departments of 4 Orthopedic Surgery and 5 Radiology, Iwate Medical School, Morioka, Japan

Objective: To clarify the clinical and magnetic resonance (MR) imaging features of a rare condition of metastasis of carcinoma to skeletal muscle.

Method: Clinicopathological findings for 12 patients (10 male, two female, age range 48–89 years, mean age 68 years) with skeletal muscle metastases of carcinomas were reviewed retrospectively.

Results: In nine of the 12 patients the skeletal muscle metastasis was presented as ‘painful mass’. The lung was found to be the most common primary source, accounting for 33% of the cases, and the lower extremity was the most common metastatic site, accounting for 67% of the current series. Diagnosis was made by biopsy in all cases. Overall, MR images were not specific, but on the gadolinium–DTPA enhanced MR images, extensive peritumoral enhancement associated with central necrosis was found in 11 of the 12 patients (92%). Seven patients died within 2–19 months (average: 9 months) after the detection of the skeletal muscle metastasis, among whom only one patient was continuously disease free for 92 months after wide excision of the metastatic lesion.

Conclusion: Skeletal muscle metastasis is often presented as a painful mass in patients with known primary carcinoma. For diagnosis, needle biopsy is mandatory. However, a painful mass with an extensive peritumoral enhancement should be highly suspected to represent carcinoma metastasis to skeletal muscles. In selected patients, wide excision with combined chemotherapy could yield unexpectedly good results.

+ For reprints and all correspondence: Kyoji Okada, Department of Orthopedic Surgery, Akita University School of Medicine, 1–1–1 Hondo, Akita 010-8543, Japan. E-mail: cshokada{at}med.akita-u.ac.jp


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