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Muscle Metastases in Different Primary Tumours

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Muscle metastases: comparison of features in different primary tumours

Background:
Muscle metastases (MM) from solid tumours are rare. The aim of this study was to describe radiological features of MM, and to compare their  patterns in different malignancies.
Methods:
A retrospective search in the statistical database of our institution revealed 61 cases of MM.  Together with our cases the present analysis comprises 461 patients (682 MM).
Results:
MM derived from the following malignancies: lung cancer (25.1%), gastrointestinal tumours (21.0%), and urological tumours (13.2%). Other  neoplasias with MM were rare. MM were localised most frequently in the thigh muscles, the extraocular musculature, and the gluteal and  paravertebral muscles. The localisation of MM was different in several primary malignancies. On computed tomography (CT), five different   patterns of MM occurred: masses with homogeneous contrast enhancement (type I, 46.5%), abscess-like lesions (type II, 27.7%), diffuse  infiltration with muscle swelling (type III, 18.1%), intramuscular calcifications (type IV, 6.5%), or MM presented as intramuscular bleeding  (type V, 1.2%). MM from several primary tumours manifested with different CT patterns. On MRI, most MM were hyperintense in comparison  to unaffected musculature in T2 weighted images and hypo- to isointense on T1 weighted images with a heterogeneous enhancement. There were no differences in MRI features of MM in different primary tumours. On ultrasound, most MM were hypoechoic. On positron emission  tomography, MM presented as focally abnormal intramuscular uptake.
Conclusion:
MM present with a broad spectrum of radiological features. Different CT imaging findings of MM were observed in different primary tumours.  The localisation of MM also varies with different primary malignancies.
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