Rao U N, Hanan S H, Lotze M T, Karakousis C P
Department of Pathology, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
J Surg Oncol. 1998 Oct;69(2):94-8. doi: 10.1002/(sici)1096-9098(199810)69:2<94::aid-jso9>3.0.co;2-4.
This small series documents the clinical and pathological features and the rarity of distant skin and soft tissue metastases from sarcomas.
Five cases of sarcomas from different anatomical locations that had metastasized to skin and subcutaneous soft tissue were identified in three women and two men. The age range was 41-77 years. The primary tumors had wide excisions, followed by either radiation or chemotherapy, or both. The histological types were epithelioid sarcoma, malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor, and leiomyosarcoma. Metastases occurred to the skin and soft tissue of the chest wall, leg, breast, and abdominal wall. The diagnosis was established by excision biopsies for three cases and by needle biopsy and fine-needle aspiration for two cases.
Three patients died within 7 months of the diagnosis of soft tissue metastases that were always histologically high grade and never solitary. One patient is alive with lung metastasis discovered 17 months after excision of primary. Lung metastases occurred either simultaneously or within a short period after soft tissue metastases.
Distant skin and soft tissue metastases from sarcomas are very rare and often occur as a terminal event.
本小系列病例记录了肉瘤远处皮肤和软组织转移的临床及病理特征以及其罕见性。
在三名女性和两名男性中，识别出五例来自不同解剖部位、已转移至皮肤和皮下软组织的肉瘤病例。年龄范围为41 - 77岁。原发肿瘤均进行了广泛切除，随后接受放疗或化疗，或两者皆用。组织学类型为上皮样肉瘤、恶性纤维组织细胞瘤、恶性外周神经鞘瘤和平滑肌肉瘤。转移至胸壁、腿部、乳腺和腹壁的皮肤及软组织。三例通过切除活检确诊，两例通过针吸活检和细针穿刺确诊。
三名患者在诊断为软组织转移后的7个月内死亡，这些转移灶组织学分级均为高级别，且从不孤立。一名患者在原发肿瘤切除17个月后发现有肺转移，目前存活。肺转移要么与软组织转移同时发生，要么在软组织转移后短时间内出现。
肉瘤远处皮肤和软组织转移非常罕见，且常为终末期事件。
