Sridhar K S, Rao R K, Kunhardt B
Cancer. 1987 Apr 15;59(8):1530-4. doi: 10.1002/1097-0142(19870415)59:8<1530::aid-cncr2820590824>3.0.co;2-h.
Hematogenous metastases to the limb skeletal muscles are extremely rare. Better understanding of the mechanisms resulting in the relative resistance of skeletal muscle to metastases could have bearing on therapeutic interventions for prevention of metastases. Three patients with non-small cell lung cancer and metastases in the proximal limb muscles are presented. Skeletal muscle metastases may present as painful masses in the proximal skeletal muscles. Subcutaneous and osseous metastases which are more frequent must be excluded by careful physical examination, bone scan and x-rays. Computed tomography (CT) can confirm the location of the tumor within the fascial planes of skeletal muscles and may help in the accurate delineation of the radiation portal. The tumor can be diagnosed and more common causes, such as hematoma or abscess, can be excluded by thin needle aspiration with cytologic examination. Clinical recognition of metastases in this unusual site is important based on our report that total tumor dose of 3600 to 4200 cGy of radiation in fractions of 300 cGy, 5 days a week, is effective in palliation of swelling and pain.
血行转移至肢体骨骼肌极为罕见。更好地了解导致骨骼肌对转移具有相对抗性的机制可能有助于预防转移的治疗干预。本文介绍了3例非小细胞肺癌并近端肢体肌肉转移的患者。骨骼肌转移可能表现为近端骨骼肌的疼痛性肿块。必须通过仔细的体格检查、骨扫描和X线检查排除更常见的皮下和骨转移。计算机断层扫描（CT）可以确定肿瘤在骨骼肌筋膜平面内的位置，并有助于准确划定放疗野。通过细针穿刺及细胞学检查可诊断肿瘤并排除更常见的病因，如血肿或脓肿。基于我们的报告，每周5天、每次300 cGy、总肿瘤剂量3600至4200 cGy的放疗对缓解肿胀和疼痛有效，因此临床上识别这一不寻常部位的转移很重要。
