J Korean Soc Radiol.  2018 May;78(5):321-329. 10.3348/jksr.2018.78.5.321.

Soft Tissue Metastasis in Patients with Primary Malignancies; Magnetic Resonance Imaging and Clinical Evaluations

• Park SM
• Lee IS
• Song YS
• Park SY
• Lee H
• Yi JH
• Song JW

• KMID: 2410721
• DOI: http://doi.org/10.3348/jksr.2018.78.5.321

Abstract

PURPOSE
The purpose of this study was to evaluate the clinical and magnetic resonance imaging (MRI) findings of soft tissue metastases distinct from benign soft tissue lesions.
MATERIALS AND METHODS
We retrospectively analyzed the MRI findings of soft tissue lesions found incidentally in patients with primary carcinoma and those without primary carcinoma from 2002-2015. To evaluate the features of soft tissue metastases distinct from benign soft tissue lesions, patients with benign soft tissue lesions were randomly selected and statistically analyzed for the distinctive features of the two groups.
RESULTS
A total of 47 patients (mean age 46.2 years) and 36 controls (mean age 46.2 years) were enrolled. Thirty six of the 47 patients were diagnosed with soft tissue metastasis, most commonly as the primary cancer (31%). The most common site of soft tissue metastasis was the lower extremities (36%) followed by the upper extremities (31%). Soft tissue metastasis was statistically significantly different from benign soft tissue lesions according to patient age, lesion size, margin, presence of degenerative changes in lesions, and presence of edema around the mass.
CONCLUSION
If the incident soft tissue lesion shows malignant features on MRI in patients with primary carcinoma or in patients over 40 years of age, the radiologist should consider the possibility of metastatic cancer.

MeSH Terms

Edema
Humans
Lower Extremity
Magnetic Resonance Imaging*
Neoplasm Metastasis*
Retrospective Studies
Soft Tissue Neoplasms
Upper Extremity

Figure

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  Fig. 1. A 50-year-old male patient diagnosed with oropharyngeal cancer two years previously and presently complaining of buttock pain. A. On coronal fat-suppressed T2-weighted image of the pelvis, a hyperintense soft tissue lesion with ill-defined margin (arrow) is seen in the muscular layer of the right buttock. Peritumoral edema (arrowheads) is also noted. B. The lesion shows homogeneous enhancement without degenerative change within the lesion (arrow) on axial fat-suppressed, contrast-enhanced T1-weighted image.

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  Fig. 2. A 47-year-old male patient with multiple bone and soft tissue lesions. After biopsy for soft tissue lesion, lung cancer was diagnosed. A. On coronal fat-suppressed T2-weighted image of pelvis, two heterogeneous soft tissue masses with peritumoral edema are seen within each iliopsoas (arrow) and adductor muscle (arrowhead). B. On another scan of same sequence, multiple bone metastatic lesions are seen (arrows). C. Metastatic mass located within the right iliopsoas muscle shows degenerative change (arrow) on axial fat-suppressed contrast enhanced T1-weighted image.

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  Fig. 3. A 67-year-old male patient with intramuscular metastasis and unknown lung cancer. A. On axial T1-weighted magnetic resonance image of left thigh, a homogeneous mass lesion (arrows) is seen in the semitendinosus muscle. B. The soft tissue lesion (arrows) shows well-defined margin without peritumoral edema on axial fat-suppressed T2-weighted image. C. On sagittal fat-suppressed, contrast-enhanced T1-weighted image, the mass lesion (arrows) shows homogeneous enhancement without degenerative change.

Reference

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