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Detection of skeletal muscle metastases on initial staging of lung cancer: a retrospective case series

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

Estimation of skeletal muscle metastases (SMMs) at the time of diagnosis and/or initial staging of lung cancer.

Materials and methods

Retrospective evaluation of clinical charts and imaging data suggestive of SMMs of patients with histology-proved lung cancer over a 5-year period.

Results

SMMs were identified in 46 out of 1,754 patients. Single and multiple (62.9 % of cases) SMMs were detected by total body multi-detector computed tomography (MDCT). They were associated with poorly differentiated (43 %) and advanced adenocarcinomas (52 %) without clinically relevant symptoms and/or signs. Psoas and buttock muscles were most frequently involved (33.3 %). MDCT findings consisted of well-defined homogeneously hyperdense oval masses (31 %), lesions with ring-like enhancement and central hypoattenuation (68 %), or large abscess-like necrotic lesions (24 %). Sonography revealed well-defined hypoechoic masses (41.6 %), ill-defined hypoechoic lesions (33.3 %), or anechoic areas with a necrotic centre (25 %). Positron emission tomography revealed that all SMMs were metabolically active.

Conclusions

SMMs are uncommon but not negligible in lung cancer, with an estimated prevalence of 2.62 % in our series. Although histology remains the recommended method, use of high-performance imaging techniques and increased clinical suspicion may improve their early detection. Efforts addressing their effect on the natural history of lung cancer are needed.

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Conflict of interest

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Author information

Authors and Affiliations

  1. Respiratory Medicine Section, Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples, Italy

    Marialuisa Bocchino

  2. Radiology Operative Unit, Department of Imaging Diagnostics, Monaldi Hospital, Naples, Italy

    Tullio Valente & Gaetano Rea

  3. Department of Radiology “Magrassi Lanzara”, Second University of Naples, Naples, Italy

    Francesco Somma

  4. Department of Pathology, Monaldi Hospital, Naples, Italy

    Ilaria de Rosa

  5. Nuclear Medicine Operative Unit, Department of Imaging Diagnostics, Monaldi Hospital, Naples, Italy

    Marco Bifulco

  6. Ospedale Monaldi, Via L. Bianchi, 5, 80122, Naples, Italy

    Marialuisa Bocchino

Authors
  1. Marialuisa Bocchino
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  2. Tullio Valente
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  3. Francesco Somma
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  4. Ilaria de Rosa
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  5. Marco Bifulco
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  6. Gaetano Rea
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Correspondence to Marialuisa Bocchino.

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Bocchino, M., Valente, T., Somma, F. et al. Detection of skeletal muscle metastases on initial staging of lung cancer: a retrospective case series. Jpn J Radiol 32, 164–171 (2014). https://doi.org/10.1007/s11604-014-0281-5

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  • DOI: https://doi.org/10.1007/s11604-014-0281-5

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