Damron T A, Heiner J
Department of Orthopedics, Upstate Medical University, State University of New York at Syracuse, USA.
Ann Surg Oncol. 2000 Aug;7(7):526-34. doi: 10.1007/s10434-000-0526-7.
Thirty patients with soft-tissue metastases were reviewed retrospectively and compared with 91 cases previously reported. Soft tissue metastases were most commonly presented to the musculoskeletal oncologist as a painful mass in patients with no history of cancer. In this setting, lung carcinoma was the most frequent primary source. The purpose of this article is to report the largest single series of distant soft-tissue metastases and to compare the findings with those of the literature.
Thirty consecutive patients were referred to musculoskeletal oncologists. Their cases were reviewed retrospectively for comparison with 91 cases from the clinical literature.
The most common clinical presentation of the soft-tissue mass was as the presenting symptom of previously undiagnosed cancer or concurrent with the primary source of cancer. A minority of cases were discovered in the setting of widespread metastases. Twenty-one new patients had carcinomas, 6 sarcomas, and 1 each multiple myeloma, lymphoma, and melanoma. Lung carcinoma was the most common primary source. The most common presenting symptom was that of a painful mass. Skeletal muscle of the thigh was the most common site. Radiological features were not specific. Soft tissue sarcoma was a common clinical misdiagnosis. Twenty-one new patients were dead of disease at a mean 5.4 months (range 1-19 months) after diagnosis of the metastasis: this percentage was similar to that reported in the literature.
In this musculoskeletal oncology referral-based clinical series, soft tissue metastases most commonly occur in patients with a painful soft tissue mass and no history of cancer. Lung is the most frequent primary source. Treatment should be individualized according to the underlying disease and its prognosis.
对30例软组织转移患者进行回顾性分析，并与之前报道的91例病例进行比较。软组织转移在肌肉骨骼肿瘤学家处就诊时，最常见的表现是在无癌症病史的患者中出现疼痛性肿块。在这种情况下，肺癌是最常见的原发灶。本文旨在报告最大的一组远处软组织转移病例系列，并将结果与文献报道进行比较。
连续30例患者被转诊至肌肉骨骼肿瘤学家处。对他们的病例进行回顾性分析，以与临床文献中的91例病例进行比较。
软组织肿块最常见的临床表现是作为先前未诊断癌症的首发症状或与癌症原发灶同时出现。少数病例是在广泛转移的情况下发现的。21例新患者患有癌，6例患有肉瘤，1例患有多发性骨髓瘤、淋巴瘤和黑色素瘤各1例。肺癌是最常见的原发灶。最常见的首发症状是疼痛性肿块。大腿骨骼肌是最常见的部位。影像学特征不具有特异性。软组织肉瘤是常见的临床误诊。21例新患者在转移诊断后平均5.4个月（范围1 - 19个月）死于疾病：这一比例与文献报道相似。
在这个基于肌肉骨骼肿瘤转诊的临床系列中，软组织转移最常发生在有疼痛性软组织肿块且无癌症病史的患者中。肺是最常见的原发灶。治疗应根据基础疾病及其预后进行个体化。
