Skeletal Muscle Metastases as Initial Presentation of Gastric Carcinoma

Abstract

Patient: Male, 67Final Diagnosis: Metastatic gastric carcinomaSymptoms: Painful swelling of soft tissueMedication: Folinic acid • fluouracil • irinotecanClinical Procedure: Radiological-pathological work-upSpecialty: OncologyObjective:Rare diseaseBackground:Gastric carcinoma is one of the most common malignancies in the world. Skeletal muscle metastases from gastric carcinoma are rare.Case Report:We report a case of a 67-year-old man patient with skeletal muscle metastasis developing from gastric carcinoma. He had a painful swelling of the left thigh. A chest computed tomography (CT) scan with enhancement showed pulmonary thromboembolism. Despite heparin therapy, edema and pain of the lower limbs increased bilaterally, so the patient underwent pelvic magnetic resonance imaging (MRI), which documented an altered signal intensity in the upper third of his thighs bilaterally. Furthermore, the examination of the ultrasound (US)-guided biopsy specimen of the left gluteal muscle showed signet ring cell adenocarcinoma metastasis. An upper gastrointestinal tract endoscopy confirmed a gastric ulceration, with a biopsy positive for signet ring cell adenocarcinoma. Because of the advanced stage of disease, the patient underwent only supportive care and died 74 days after admission.Conclusions:Skeletal muscle metastasis may be the initial presentation of gastric carcinoma and diagnosis could be difficult. Biopsy is mandatory for diagnosis.

Pulmonary Adenocarcinoma Presenting as Paraspinal Muscle Metastatic Mass

“…An isolated, painful skeletal muscle metastasis as the initial manifestation of an otherwise asymptomatic primary malignancy, as in our patient, is uncommon [ 6 , 9 , 14 ]. Muscular metastases typically present as a painful and frequently palpable mass with or without localized swelling [ 2 ].…”

“…Nearly all types of lung carcinoma, along with renal, bladder, and gastrointestinal tract carcinomas, have been known to metastasize to skeletal muscle [ 3 , 5 , 6 ]. The most common metastatic sites of lung cancer are the adrenal glands, liver, bone, and brain—as seen with the renal and liver lesions discovered in our case [ 7 ].…”

Multiple skeletal muscle metastases from poorly differentiated gastric adenocarcinoma

“…Gastric cancer rarely metastasizes to skeletal muscle, and such metastases are generally associated with widespread metastatic disease and poor prognosis. Because of their rarity and particular clinical characteristics, these metastases are challenging to diagnose [ 8 ]. To our knowledge, 21 cases of intramuscular metastases from gastric carcinoma, including our case, have been reported in the literature since 1970.…”

“…To our knowledge, 21 cases of intramuscular metastases from gastric carcinoma, including our case, have been reported in the literature since 1970. These reported cases contain 17 males and 4 females, and their mean age was 62 years (range, 47–89 years) (Table 1 ) [ 3 , 6 , 8 – 24 ]. In some patients, including ours, metastases developed in multiple skeletal muscles.…”

Effect of Splenectomy Combined with Resection for Gastric Carcinoma on Patient Prognosis

“…Gastric cancer is one of the most common gastrointestinal malignancies; the World Health Organization ranks it fourth worldwide and third in China as a cause of cancer-related morbidity and mortality [1]. D2 radical gastrectomy is the best therapeutic option for patients with stage II and III gastric cancer [2,3], and splenectomy combined with gastrectomy does not meaningfully improve patient prognosis [4].…”