Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2012 Jun 1;118(11):2900-4. doi: 10.1002/cncr.26590. Epub 2011 Oct 11.
Sarcoma metastases to the skin are relatively rare, because most involve the lung, liver, or deep soft tissues. The authors of this report examined the distribution and clinical significance of cutaneous and superficial subcutaneous sarcoma metastases.
Sixty-five patients with histologically confirmed dermal and superficial subcutaneous sarcoma metastases were identified in pathology files from more than 25,000 patients with sarcoma who were evaluated at The University of Texas M. D. Anderson Cancer Center from 1989 to 2009. Pathology slides and clinical and radiological information were evaluated.
Cutaneous metastases were documented histologically in <0.25% of patients. The mean patient age was 49 years (range, 16-79 years), and there was an equivalent ratio of men to women. The most common source of metastasis was leiomyosarcoma (28 of 65 patients; 43%). The most common region of first skin metastasis was head and neck (33 patients; 51%), and the scalp predominated (25 patients; 38%). The mean time from primary tumor diagnosis to skin metastasis was 48 months (range, 0-166 months). Fifty-three patients (81%) had multiple metastases (skin and other). Among the patients who had complete clinical information available, 31 patients (62%) had other metastases diagnosed before skin involvement, 17 patients (34%) had skin metastases diagnosed first, and 2 patients (4%) had simultaneous presentation. The following clinical outcomes were documented: Twenty-nine patients (45%) died of disease, 24 patients (37%) remained alive with disease, and 12 patients were lost to follow-up. The mean time to death was 80 months (range, 9-224 months) after primary diagnosis, 45 months (range, 5-94 months) after the first metastasis to any site, and 27 months (range, 5-65 months) after the first skin metastasis.
Sarcoma metastases to the skin are rare. In this large study, leiomyosarcoma was the most common source, and the scalp was the most frequent site. The majority of patient with skin metastases harbored metastases elsewhere. However, skin was the initial site of metastasis in approximately 1 in 3 patients. Thus, clinical correlation is needed before establishing a diagnosis of primary cutaneous sarcoma, particularly leiomyosarcoma of scalp. Finally, the current results indicated that skin metastasis usually is a late event in sarcoma clinical progression and heralds a poor prognosis.
肉瘤转移至皮肤相对少见，因为大多数肉瘤转移至肺部、肝脏或深部软组织。本文作者检查了皮肤和浅层皮下肉瘤转移的分布和临床意义。
从 1989 年至 2009 年，在德克萨斯大学安德森癌症中心对超过 25000 例肉瘤患者进行评估，作者从病理档案中发现 65 例经组织学证实的皮肤和浅层皮下肉瘤转移患者。评估了病理切片和临床及影像学信息。
<0.25%的患者有皮肤转移的组织学记录。患者平均年龄为 49 岁（范围 16-79 岁），男女比例相当。最常见的转移来源是平滑肌肉瘤（28/65 例；43%）。皮肤转移的第一个最常见部位是头颈部（33 例；51%），头皮为主（25 例；38%）。从原发肿瘤诊断到皮肤转移的平均时间为 48 个月（范围 0-166 个月）。53 例（81%）有多处转移（皮肤和其他部位）。在有完整临床资料的患者中，31 例（62%）在皮肤受累前诊断出其他转移，17 例（34%）首先诊断为皮肤转移，2 例（4%）同时出现。记录了以下临床结果：29 例（45%）死于疾病，24 例（37%）疾病仍在进展，12 例失访。从初次诊断到死亡的平均时间为 80 个月（范围 9-224 个月），从任何部位的第一次转移到死亡的平均时间为 45 个月（范围 5-94 个月），从第一次皮肤转移到死亡的平均时间为 27 个月（范围 5-65 个月）。
肉瘤皮肤转移罕见。在这项大型研究中，平滑肌肉瘤是最常见的来源，头皮是最常见的部位。大多数皮肤转移患者还有其他部位的转移。然而，大约 1/3 的患者最初的转移部位是皮肤。因此，在诊断原发性皮肤肉瘤，特别是头皮平滑肌肉瘤之前，需要进行临床相关性检查。最后，目前的结果表明，皮肤转移通常是肉瘤临床进展的晚期事件，并预示着预后不良。
