Carcinoma Lung Presenting with Skeletal Muscle Metastasis: Case Report with Review of Literature

Lung cancers usually present very late with distant metastasis, thereby carrying a poor prognosis. Metastasis at unusual sites such as extremity musculature does create a diagnostic challenge. This leads to delay in diagnosis and treatment initiation and further worsens the prognosis of the patient. Not many cases have been reported as of now and no standard guidelines are available regarding clinical approach in such cases. We have presented one of such cases to emphasize on importance of early detection and differentiation of such lesions from primary soft tissue malignancies.

Gluteal muscle metastasis with peritoneal dissemination from gastric cancer during postoperative adjuvant chemotherapy: a case report

Background Skeletal muscle metastasis from gastric cancer is rare and has a poor prognosis. We reported a case of gluteal muscle metastasis with peritoneal dissemination from gastric cancer during postoperative adjuvant chemotherapy. Case presentation A 64-year-old man with gastric cancer underwent distal gastrectomy with D2 lymph node resection. The pathological diagnosis was poorly differentiated adenocarcinoma and signet cell carcinoma, T3N3bM0, Stage IIIC. Metastases were found in all regional lymph nodes, except 11p. The resection margin was negative. S-1 plus docetaxel therapy was administered as postoperative adjuvant chemotherapy. Six month post-operation, the patient presented with right gluteal muscle tenderness and abdominal distension. Computed tomography revealed a solid mass in the right gluteal muscle, a disseminated nodule on the abdominal wall, and massive ascites. Pathological examination of the gluteal muscle revealed signet cell carcinoma, similar to the resected gastric cancer. The tumor was diagnosed as gastric cancer metastases. Ascites cytology was class V. Thereafter, the patient underwent one course of capecitabine plus cisplatin combined with trastuzumab. Radiation therapy was also administered to relieve the pain of gluteal muscle metastasis. However, chemoradiotherapy was ineffective, and the patient died 2 months after the recurrence. Conclusions Skeletal muscle metastasis and peritoneal dissemination during adjuvant chemotherapy indicated a poor prognosis.

Ossifying Skeletal Muscle Metastases from Colon Cancer: A Case Report and Literature Review

Background: Colon cancer is a common malignant disease of the gastrointestinal tract and usually occurs at the junction of the rectum and sigmoid colon. Lymphatic and hematogenous metastases occur frequently in colon cancer and the most common metastatic sites include the regional liver, lung, peritoneum, bone, and lymph nodes. As a manifestation of advanced tumor spread and metastasis, soft tissue metastasis, especially skeletal muscle metastasis ossification caused by colon cancer, is rare, accounting for less than 1% of metastases.Case presentation: In this study, we report a rare case of a 43-year-old male patient who developed an ossifying skeletal muscle metastasis of the right proximal thigh with severe pain at 5 months after colon cancer was diagnosed, who subsequently from the developed metastasis. The patient was admitted to the hospital because of pain caused by a local mass on his right thigh. Positron emission tomography-computed tomography showed multiple lymphadenopathy metastases around the abdominal aorta without lung or liver metastases. Color ultrasound revealed a mass located in the skeletal muscle and the results of histological biopsy revealed a poorly differentiated adenocarcinoma suspected to be distant metastases from colon cancer and immunohistochemistry showed small woven bone components that were considered to be ossified. Conclusion: Although ossifying skeletal muscle metastases is rare, its potential malignancy is high. With advances in examinations and treatment modality, Positron emission tomography-computed tomography, collagen gel droplet culture drug-sensitivity test and genetic tests are recommended to optimize comprehensive and individual treatment modality to prolong patient survival.