The role of radiological and hybrid imaging for muscle metastases: a systematic review

Lupi, Amalia; Weber, Michael; Fiore, Paolo Del; Rastrelli, Marco; Guglielmi, Giuseppe; Stramare, Roberto; Quaia, Emilio; Cecchin, Diego; Giraudo, Chiara

doi:10.1007/s00330-019-06555-4

Cited by 8 publications

(8 citation statements)

References 47 publications

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“…As reported in a systematic review of imaging characteristics found in skeletal muscle lesions, among 281 patients with skeletal muscles metastases, the majority presented on CT with intravenous contrast as abscess-like lesions with central low-attenuation and rim-enhancement, followed by homogeneous contrast-enhanced lesions, hypodense lesions (as in our case), and more infrequently isodense. 12 Interestingly, between the four studies reviewed in this systematic review that described skeletal muscle metastases as hypodense, two are focused on lesions in the iliopsoas muscle as reported in our case. 13 , 14 …”

Section: Discussionmentioning

confidence: 89%

Pancreatic cancer with a skeletal muscle metastasis - A case presentation and literature review

Spetsieris¹,

Bobba²,

Bhandari³

et al. 2022

Journal of Community Hospital Internal Medicine Perspectives

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One-half of patients with newly diagnosed pancreatic cancer will have metastatic disease at the time of diagnosis, mainly due to its non-specific initial clinical presentation which includes abdominal pain, dyspepsia, weight loss, bowel habit changes, jaundice and pruritus. The signs, symptoms and stage of the disease at initial diagnosis depends on the origin of the primary tumor, with tumors of the head presenting earlier with obstructive symptoms while tumors of the body/tail are often diagnosed at an advanced stage due to their non-specific presentation. The most common sites of metastasis are the lymph nodes, liver, lung, and peritoneum. The presence of metastatic disease in the skeletal muscles is a rare manifestation of pancreatic cancer and has been described in a limited number of cases. We report the case of a pancreatic cancer patient with a solitary muscle lesion as the only site of extra-nodal metastasis upon initial presentation.

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Section: Discussionmentioning

confidence: 89%

Pancreatic cancer with a skeletal muscle metastasis - A case presentation and literature review

Spetsieris¹,

Bobba²,

Bhandari³

et al. 2022

Journal of Community Hospital Internal Medicine Perspectives

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“…There remains a clinical challenge when patients are on anticoagulation, as a possible differential of an intramuscular mass would be a hematoma, as in our case. On CT, intramuscular metastases have varied patterns, but a hematoma may demonstrate a multicystic or fluid-fluid level [ 29 , 30 ]. On MRI, intramuscular metastasis demonstrates poorly defined margins, T1-weighted low/heterogeneous signal, T2-weighted high signal, restricted diffusion, heterogeneous or ring enhancement, or central necrosis with peritumoral edema [ 23 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…On CT, intramuscular metastases have varied patterns, but a hematoma may demonstrate a multicystic or fluid-fluid level [ 29 , 30 ]. On MRI, intramuscular metastasis demonstrates poorly defined margins, T1-weighted low/heterogeneous signal, T2-weighted high signal, restricted diffusion, heterogeneous or ring enhancement, or central necrosis with peritumoral edema [ 23 , 29 ]. On MRI, hematomas have variable T1-weighted and T2-weighted signals, depending on the age of blood products [ 31 ] and are typically non-enhancing, although rim enhancement can sometimes be seen [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiac and Intramuscular Metastases Following Nephroureterectomy for Metachronous Urothelial Carcinoma

Chan,

Wong Su Lin

2024

Am J Case Rep

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Patient: Male, 58-year-old Final Diagnosis: Metastatic urothelial carcinoma Symptoms: Right scapular lump • shortness of breath Clinical Procedure: — Specialty: Oncology • Radiology Objective: Rare disease Background: We present a case of metachronous cardiac and intramuscular metastases in a patient with a known history of radical nephroureterectomy for upper-tract urothelial carcinoma (UTUC). Case Report: A 58-year-old man had a history of metachronous renal pelvis urothelial carcinoma with prior left radical nephroureterectomy. He was also diagnosed with malignancy-associated deep vein thrombosis (DVT) and was on rivaroxaban. He presented at an oncology follow-up consult with shortness of breath and right scapular lump. CT scan revealed a soft-tissue mass at the surgical bed suspicious for local recurrence, as well as intracardiac hypodensities and intramuscular nodules in the right latissimus dorsi and right adductor muscles. The intracardiac hypodensities were located in the left atrial appendage and inter-atrial septum. Given that the patient had a history of DVT and in a pro-thrombotic state, differentials for the intracardiac densities included intracardiac thrombi or metastases. The intramuscular hypodensities were rim-enhancing. Given that the patient was on rivaroxaban, differentials included hematomas or metastases. As there was no overlying bruising and the lesions remained unchanged in size clinically, they were treated as metastases. The patient was treated with clexane but re-presented with worsening of shortness of breath and palpitations. CT scan showed increased size of intracardiac lesions, suggesting no response to anticoagulation, and therefore were likely metastatic in nature. He completed a 2-year course of IV pembrolizumab and was in complete remission. Conclusions: Our case highlights the importance of this clinically challenging scenario when patients with known malignancy and on anticoagulation present with cardiac or musculoskeletal symptoms. Though these patients are at risk of thrombus and haematoma, cardiac and intramuscular metastasis should be considered, as the prognosis is guarded.

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“…Only one masseter muscle metastasis was incidentally found in carotid angiography ( 7 ). Muscle masses include a large variety of benign and malignant soft tissue lesions of diverse histological nature ( 20 ). In further identification, US is often used as the first imaging examination, for its convenience, free of radiation, and ability to detect blood supply of lesions.…”

Section: Discussionmentioning

confidence: 99%

Masseter Muscle Metastasis of Renal Cell Carcinoma: A Case Report and Literature Review

Qin

Zhang

et al. 2022

Front. Oncol.

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BackgroundPatients with renal cell carcinoma are often troubled by metastases, but masseter muscle metastases are particularly rare.Case PresentationWe reported a 76-year-old male who did not show any recurrence and metastasis after the nephrectomy until 5 years later. The metastatic mass was found with the protrusion of masseter muscle area. Computed tomography and ultrasonography indicated a hypervascular mass, and pathology confirmed the masseter muscle metastasis of renal cell carcinoma. Complete metastasectomy was performed with the preserval of facial function and appearance. No local recurrence or distant metastasis was found in follow-up.ConclusionOur report indicates masseter muscle can be a metastatic site of renal cell carcinoma, regardless of its rarity. Long-term comprehensive surveillance is needed for patients with renal cell carcinoma. Muscle metastases can disguise as benign mass, while multiple imaging and pathology are important in identifying their sources. If possible, complete metastasectomy with function retention is recommended for masseter muscle metastases.

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The role of radiological and hybrid imaging for muscle metastases: a systematic review

Cited by 8 publications

References 47 publications

Pancreatic cancer with a skeletal muscle metastasis - A case presentation and literature review

Pancreatic cancer with a skeletal muscle metastasis - A case presentation and literature review

Cardiac and Intramuscular Metastases Following Nephroureterectomy for Metachronous Urothelial Carcinoma

Masseter Muscle Metastasis of Renal Cell Carcinoma: A Case Report and Literature Review

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