Herring C L, Harrelson J M, Scully S P
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710.
Clin Orthop Relat Res. 1998 Oct(355):272-81. doi: 10.1097/00003086-199810000-00029.
The records of 15 patients with metastatic carcinoma to skeletal muscle treated between 1979 and the present were reviewed. Fourteen patients were referred with a diagnosis of soft tissue sarcoma and one with suspected infection. There was a previous diagnosis of carcinoma in eight patients but seven patients had no prior diagnosis of a known malignancy. Primary tumors were lung (eight), melanoma (two), gastrointestinal (one), kidney (one), and bladder (one). No primary tumor could be identified in two patients. Local control of metastatic lesions was achieved by radiotherapy in 11 patients as an initial measure. Two patients underwent wide excision and one declined treatment for local tumor control. Eight patients died within 12 months of presentation and survival analysis indicated a 25% overall survival at 60 months. Two patients remained free of disease at 132 months and 72 months. From this study and a review of 52 cases reported in the literature, the authors are unable to find any clinical or radiographic characteristics that distinguish metastatic carcinoma to muscle from soft tissue sarcomas. Surgical resection can be reserved for cases in which radiation does not provide local control.
回顾了1979年至目前期间接受治疗的15例发生骨骼肌转移癌患者的记录。14例患者因软组织肉瘤诊断前来就诊,1例因疑似感染前来就诊。8例患者曾有癌症诊断,但7例患者既往无已知恶性肿瘤诊断。原发肿瘤为肺癌(8例)、黑色素瘤(2例)、胃肠道癌(1例)、肾癌(1例)和膀胱癌(1例)。2例患者无法确定原发肿瘤。11例患者最初采用放射治疗实现了转移灶的局部控制。2例患者接受了广泛切除,1例拒绝接受局部肿瘤控制治疗。8例患者在就诊后12个月内死亡,生存分析表明60个月时总体生存率为25%。2例患者分别在132个月和72个月时仍无疾病复发。通过对本研究及文献报道的52例病例进行回顾,作者未能发现任何可将肌肉转移癌与软组织肉瘤区分开来的临床或影像学特征。手术切除可保留用于放疗无法实现局部控制的病例。