Osteogenic sarcoma with skeletal muscle metastases

Abstract

Two cases of osteogenic sarcoma with skeletal muscle metastases are described. A 40-year-old woman presented with progressive swelling of both calves and a soft tissue back lump. She had been diagnosed with mandibular chondroblastic osteogenic sarcoma 6 years earlier. Radiographs showed calcified masses. MRI scans and bone scintigraphy revealed multiple soft tissue masses in both calves. Bone scintigraphy also showed uptake in the back lump, right thigh and left lung base. Biopsy confirmed metastatic chondroblastic osteogenic sarcoma, which initially responded well to chemotherapy. However, the metastatic disease subsequently progressed rapidly and she died 21 months after presentation. The second case concerns a 20-year-old man who presented with a pathologic fracture of the humerus, which was found to be due to osteoblastic osteogenic sarcoma. He developed cerebral metastases 17 months later, followed by metastases at other sites. Calcified masses were subsequently seen on radiographs of the abdomen and chest. CT scans confirmed the presence of densely calcified muscle metastases in the abdominal wall, erector spinae and gluteal muscles. The patient's disease progressed rapidly and he died 30 months after presentation.

Isolated subcutaneous metastasis of osteosarcoma 5 years after initial diagnosis

“…Neuroblastoma is known to sometimes present as multiple dark blue cutaneous metastases (''blueberry muffin baby''). The occurrence of subcutaneous metastases from any musculoskeletal sarcoma appears to be extremely rare [3,4].…”

Multiple Skeletal Muscle Metastases in a Case of Transitional Cell Carcinoma of Bladder Detected by F-18 FDG PET/CT

“…Thigh and calf muscles are common sites and the majority of the cases are secondary to lung carcinoma [1]. Other tumours producing metastasis to skeletal muscle include osteogenic sarcoma [2,3], melanoma [4], adenocarcinoma of colon [5], stomach [6], ovary [7], leiomyosarcoma [8], mesothelioma [9] and nasopharyngeal carcinomas [10]. Metastasis from transitional cell carcinoma to brain [11], skin [12] and pericardial effusion [13] are also described.…”

Diagnosis and Planning in the Management of Musculoskeletal Tumors - A Review

“…Less likely are Ewing's sarcomas, metastasis from neuroblastoma, or involvement by leukemia. The peak incidence of primary osteosarcoma occurs in the second decade of life, which corresponds to the maximal period of Pertinent information from the history includes night pain/rest pain and increase in the size of a mass 5 . Night pain is less likely in a stress reaction/fracture.…”

“…Malignant bone tumors are usually painful but the benign tumour may present without pain (simple bone cyst) in children and the same manifestation may be experienced in metastatic bone lesion or metabolic bone diseases in elderly. Malignant soft tissue tumors most often present as a painless enlarging mass and occasionally with pain due to pressure on surrounding tissue (e. g., nerves) or due to erosion of an adjacent bone [3][4][5] .…”