Femoral muscle metastasis from gastric carcinoma

Abstract

REFERENCES Femoral muscle metastasis from gastric carcinoma Mide kanserinin femoral kasa metastaz› To the Editor,The incidence of skeletal metastasis from gastric cancer ranges from 0.8-17.5% (1,2). We report a patient with intramuscular metastasis to his left thigh diagnosed 24 months after gastrectomy for a T3N1 adenocarcinoma of the stomach. Magnetic resonance imaging (MRI) revealed a soft tissue mass in the upper third of his left thigh, for which he was operated twice and complete resection was achieved. The biopsy showed metastasis from the gastric adenocarcinoma. Subsequently, the patient underwent irradiation. The patient lived for 30 months after the completion of radiation therapy for the metastasis, and his overall survival was 47 months. In this report, the metastatic pattern of gastric carcinoma was unusual, as it was not developed in the liver and lung but in skeletal muscles.Radiographic evaluation of the mass often provides valid information on intramuscular metastatic tumors. In MRI, metastatic lesions are usually of low signal intensity on T1-weighted images and high signal intensity on T2-weighted images (3,4). In this case, sagittal T2-weighted images depicted the involved muscles of the left thigh with long T2 values and diffuse swelling. Axial T2-weighted images were useful for separation of the involved from the uninvolved muscles (Figure 1).

Gastric adenocarcinoma presenting with multiple skeletal muscle metastases

“…A wedge resection with a tumour-free margin may offer a better quality of life 18. Combined radiotherapy and surgical resection may prolong survival in patients with single SMM 19. Palliative chemotherapy with 5-fluorouracil-containing regimens, in selected patients, may cause a reduction in pain and the size of the metastatic lesion 20…”

Metastatic involvement of skeletal muscle from gastric adenocarcinoma

“…Chemotherapy is indicated for advanced disease with extensive metastatic burden [9, 13, 16]. Surgical excision may even prolong patient survival per some accounts, but the evidence is limited [9, 17].…”

Metástasis muscular de adenocarcinoma gástrico: A propósito de un caso y revisión de la literatura

“…El tejido muscular supone alrededor del 50% de la masa corporal y está altamente vascularizado, por lo que la rareza de desarrollar metástasis musculares puede estar relacionada con los cambios del flujo sanguíneo en estos tejidos, la destrucción de las células tumorales por el movimiento muscular, y la inhibición de la proliferación tumoral por el ácido láctico, las proteasas y el pH muscular, que pueden ejercer como factores protectores para el desarrollo de enfermedad a este nivel (2,5,6,7).…”