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Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver. Extrahepatic metastasis occurs mostly through the hematogenous route and is seen in around one-third of patients with the common sites of involvement being the lungs, regional lymph nodes, bone, adrenal glands, and pancreas. Soft-tissue metastasis from HCC is an extremely rare condition. Here, we present a rare case of an elderly male, with HCC presenting as a soft-tissue mass in the gluteal region. We further provide a detailed discussion regarding the investigative approach used to arrive at the diagnosis and the treatment modalities offered. Case reports like this may offer insight into the possibilities of such unusual presentations and aid the clinician in his endeavor to the early diagnose and treat the patient.
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Neuroblastoma is one of the most common tumors in children. Cases where an isolated soft-tissue metastasis mass is the initial symptom are rare, with only four such cases reported to date. We describe the imaging findings of ten cases of neuroblastoma patients in our hospital with superficial soft tissue mass (SSTM) as the primary symptom. The main ultrasound finding of SSTM was hypoechoic masses or scattered speck-like hyperechoic masses. However, when this type of SSTM is caused by soft tissue metastasis, the location is often atypical, and ultrasound findings are difficult to distinguish from other benign diseases. Therefore, this research should remind clinicians to recognize atypical presentations of this common childhood malignant tumor. Radiologists should also consider the possibility of neuroblastoma when finding this type of SSTM with atypical ultrasound features.
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Background@#Follicular carcinomas occur frequently in women beyond the 5th decade of life as a slow-growing thyroid nodule. They are known to invade locally and metastasize distantly. Common sites for distant metastases are lungs and bones. The bones often involved are axial skeleton such as vertebrae, sternum, and skull. Metastasis to scapula is an infrequent presentation and skeletal muscle metastasis is extremely rare.@*Methods@#Case Report@*Results@#We present a case of metastatic follicular thyroid carcinoma that manifested as a large scapular mass on the right shoulder of a 65-year-old female patient. MRI of the right shoulder revealed a large lobulated mass with central necrosis and non-delineation of the 4 rotator cuff muscles. Biopsy of the scapular mass revealed an invasive metastatic follicular carcinoma. A thyroid ultrasound showed a significant right thyroid nodule. The patient underwent total thyroidectomy and subsequent right total scapulectomy with biceps tendon transplantation attached to the clavicle. Histopathologic reports from both operations are consistent with invasive follicular thyroid carcinoma. The patient underwent radioiodine therapy. Follow-up showed no evidence of any functioning metastasis.@*Conclusion@#Soft tissue metastasis is an uncommon initial presentation of follicular thyroid carcinoma. Synchronous metastasis to the bone and soft tissue particularly on the right scapula and surrounding muscles is a rare occurrence that warrants this report.
Assuntos
Neoplasias da Glândula TireoideRESUMO
Objective:To explore the outcome of soft tissue sarcoma (STS) on patients with soft tissue metastasis. Methods:We ana-lyzed 25 STS patients with soft tissue metastasis primarily localized on extremity and trunk. The study was conducted from June 2010 to June 2016 by retrospective analysis of the clinical and pathological characteristics of the patients. The assessed endpoints were overall survival. Results:Six patients (24%) had synchronous soft tissue metastasis, and 19 patients (76%) had metachronous metasta-sis. The average time for primary tumor recession of metastatic lesions was 45.3 months. Metastases were most common in parts of the trunk in 18 patients (72%), followed by the head and neck in 5 patients (20%). Eleven patients (44%) with lung metastasis had poor prognosis. Conclusion:STS occurred more rarely in soft tissue metastasis than in pulmonary metastasis. Neoadjuvant chemotherapy and surgical treatment were the major therapies employed. Targeted therapy as a new treatment rendered good results.
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Patients with stage IV metastatic melanoma have been traditionally managed with mainly palliative therapy such as chemotherapy, radiation therapy or biologic therapy, yet their overall survival is unsatisfactory. Several recent series have indicated a long-term survival benefit after complete resection, (termed "metastasectomy") of distant metastatic foci in patients with metastatic melanoma. Unlike other palliative modalities, surgery like metastasectomy can rapidly render a patient clinically disease-free with rather minimal morbidity, a short-term of hospitalization and a quick recovery time. This may prolong the survival and improve the quality of life of patients with stage IV melanoma if all the clinicoradiologically-evident tumors can be completely resected. We report herein on a case of performing metastasectomy in a patient who had malignant melanoma with soft tissue metastasis of the breast (T3a/bN0M1a), even though there was a regrettable result.