Ketata W, Feki W, Msaad S, Yangui I, Ayoub A
Service de Pneumo-Allergologie, CHU Hédi Chaker, 3029 Sfax, Tunisie.
Rev Mal Respir. 2011 Jan;28(1):71-4. doi: 10.1016/j.rmr.2010.04.020. Epub 2011 Jan 8.
The diagnosis of nonsmall cell lung cancer is made at a metastatic stage in 25% of cases. The most frequent sites are the lung, liver, bone, the adrenal glands and the central nervous system. Skeletal muscle metastases are uncommon and are rarely the first manifestation of a neoplastic process.
We report the case of 55 years old man presenting with a hard painless swelling of the left arm. A scan guided biopsy revealed infiltration of the muscle by a thyroid transcription factor 1 (TTF1) positive adenocarcinoma. A CT scan of the chest showed a partially necrotic tissue mass with moderate uptake of contrast. The patient was treated by chemotherapy with gemcitabine and carboplatine. The progress was unfavourable with the appearance of a second muscular metastasis in the thigh and the patient died 3 months after diagnosis.
Skeletal muscle metastases are rarely described in lung cancer and they are an exceptional presentation of the tumour. Their symptoms can be misleading and delay diagnosis.
25%的非小细胞肺癌患者在诊断时已处于转移阶段。最常见的转移部位是肺、肝、骨、肾上腺和中枢神经系统。骨骼肌转移并不常见，很少是肿瘤进程的首发表现。
我们报告一例55岁男性，其左臂出现无痛性硬结。经扫描引导活检显示，肌肉被甲状腺转录因子1（TTF1）阳性腺癌浸润。胸部CT扫描显示有部分坏死的组织块，造影剂摄取中等。患者接受了吉西他滨和顺铂化疗。病情进展不利，大腿出现了第二个肌肉转移灶，患者在诊断后3个月死亡。
肺癌中骨骼肌转移很少被描述，它们是肿瘤的一种特殊表现形式。其症状可能会误导诊断并导致诊断延迟。
