Takasawa H, Okada K, Ueki K
No Shinkei Geka. 1976 Jan;4(1):79-87.
The authors report and discuss a calvalial metastasis of alveolar soft part sarcoma which primarily developed in the left arm. A 13-year-old girl noted a painless tumor in the left upper arm at the age of 7 years. The tumor was excised and histologically alveolar soft part sarcoma. 5 years later, a rapid growing tumor was noted in the parietal area. The craniograms showed the left parietal bone defect. The chest X-ray showed a few large oval metastatic shadows. The left common carotid angiograms demonostrated high vascularities with irregular vessels in the arterial phase and a homogenous blush or stain in the venous phase. It was thought likely to meningioma. In selective external carotid angiograms, early arterial phase showed a few of vascular streaks in beads, fine tortuous vessels and early conspicuous filling of enlarged vein. Paradoxically, despite evidence of rapid shunting of blood from the lesion. "Wash out" of contrast media from the lesion was slow. Above mentioned angiographic appearance was consistent with that of cases reported by Rosenbaum, A.E., and was considered characteristic features of alveolar soft part sarcoma, meningiosarcoma and malignant melanoma. It must be emphasized that the slective angiography is important to differentiate angiographically alveolar soft part sarcoma, meningiosarcoma, malignant melanoma from meningioma or angioma. Radiotherapy is not effective to the pulmonary metastatic lesion. Selective angiography should be emphazied to be essential for differentiation of alveolar soft part sarcoma from angioma or meningioma.
