Sarcoma brain metastases: Tertiary cancer center experience.

OBJECTIVE: Brain metastasis (BM) from bone and soft tissue sarcomas (STS) is very rare and mostly predicts dismal prognosis. Owing to its' rarity, data on optimal therapy including surgical management, chemotherapy, and radiotherapy is scarce. We sought to assess the prevalence, disease characteristics, and outcomes of BM in bone and STS patients treated at a single institution. METHODS: A retrospective chart review was performed for consecutive bone and STS patients treated at King Hussein Cancer Center from 2007 to 2020. Patients with BM were identified. Survival was estimated by the Kaplan-Meier method. Factors of possible effect on OS was examined in univariate analysis. Survival comparisons were carried out by the log-rank test. RESULTS: A total of 1,548 bone and STS patients were treated at our center during the eligibility period. We identified 18 patients (1.1%) who had BM at initial presentation (n = 16, 1.0%) or during follow up (n = 2; 0.1%). Fourteen patients (77.8%) were male. The median age was 29.5 years (range: 0.1-60 years). The primary tumor was most commonly located in the extremities (61%). Ten different histopathological subtypes were encountered; Ewing sarcoma (ES) was the most common (n = 4; 28%). Twelve patients (67%) had lung metastasis as the first site of metastatic disease. BM was detected at a median time of 12 months following sarcoma diagnosis (range: 1-71 months). A total of 10 patients (56%) had solitary metastasis and 4 patients (22.2%) had hemorrhagic metastasis. The most common location of brain metastatic lesions was the occipital lobe (n = 4; 22.2%). Thirteen patients received treatment for metastatic brain sarcoma. The most common treatment modality was radiotherapy, received by a total of 10 patients (55.5%), followed by surgical intervention performed in a total of 5 patients (27.7%), The other treatment modalities included combined chemo-radiotherapy (n = 2), targeted therapy plus chemotherapy, and targeted therapy plus radiotherapy (n = 1, each). At a median follow up of 10 months following detection of BM, the median OS was 4.0 months; (95% CI: 2.54-5.46). We did not identify any factor that influenced OS in univariate analysis. CONCLUSION: Sarcoma BM is exceedingly rare and herald's dismal prognosis. ES was a major histological subtype accounting for BM metastasis in our series.

Metastatic myxoid liposarcoma of the brain: a case report and review of the literature.

AIM: Myxoid liposarcoma (MLS) is a rare malignant soft-tissue neoplasm in which brain metastasis is still considered rare. We present a case of MLS brain metastasis and review of the literature. CASE PRESENTATION: A 24-year-old male patient presented with headache, decreased level of consciousness and vomiting. He was treated for distal right thigh MLS 2-years ago. Imaging studies of the brain showed a left frontal intracranial mass. The patient underwent surgical resection followed by stereotactic radiosurgery. The histopathological study revealed metastatic myxoid/roundcell liposarcoma infiltrating the bone and peripheral margins. CONCLUSION: Treatment options for MLS usually includes surgical resection and adjuvant radiotherapy. A case-by-case based multidisciplinary approach is recommended for the management of similar cases.