European Radiology

, Volume 20, Issue 3, pp 649–658 | Cite as

Skeletal muscle metastases: primary tumours, prevalence, and radiological features

  • Alexey SurovEmail author
  • Michael Hainz
  • Hans-Jürgen Holzhausen
  • Dirk Arnold
  • Michaela Katzer
  • Joerg Schmidt
  • Rolf Peter Spielmann
  • Curd Behrmann



Although skeletal muscles comprise nearly 50% of the total human body mass and are well vascularised, metastases in the musculature are rare. The reported prevalence of skeletal muscle metastases from post-mortem studies of patients with cancer is inconstant and ranges from 0.03 to 17.5%.

Materials and methods

Of 5,170 patients with metastasised cancer examined and treated at our institution during the period from January 2000 to December 2007, 61 patients with muscle metastases (80 lesions) were identified on computed tomography (CT). Genital tumours (24.6%) were the most frequent malignancies metastasising into the skeletal musculature, followed by gastrointestinal tumours (21.3%), urological tumours (16.4%), and malignant melanoma (13.1%). Other primary malignancies were rarer, including bronchial carcinoma (8.2%), thyroid gland carcinoma (4.9%), and breast carcinoma (3.3%). In 8.2%, carcinoma of unknown primary was diagnosed.


Skeletal muscle metastases (SMM) were located in the iliopsoas muscle (27.5%), paravertebral muscles (25%), gluteal muscles (16.3%), lower extremity muscles (12.5%), abdominal wall muscles (10%), thoracic wall muscles (5%), and upper extremity muscles (3.8%). Most (76.3%) of the 80 SMM were diagnosed incidentally during routine staging CT examinations, while 23.7% were symptomatic.


Radiologically, SMM presented with five different types of lesions: focal intramuscular masses (type I, 52.5% of SMM), abscess-like intramuscular lesions (type II, 32.5%), diffuse metastatic muscle infiltration (type III, 8.8%), multifocal intramuscular calcification (type IV, 3.7%) and intramuscular bleeding (type V, 2.5%).


Skeletal muscle metastases Prevalence CT imaging 



We thank Edith Disputh for the careful preparation of the manuscript.


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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Alexey Surov
    • 1
    Email author
  • Michael Hainz
    • 2
  • Hans-Jürgen Holzhausen
    • 2
  • Dirk Arnold
    • 3
  • Michaela Katzer
    • 4
  • Joerg Schmidt
    • 5
  • Rolf Peter Spielmann
    • 1
  • Curd Behrmann
    • 1
  1. 1.Department of RadiologyMartin-Luther-University Halle-WittenbergHalleGermany
  2. 2.Department of PathologyMartin-Luther-University Halle-WittenbergHalleGermany
  3. 3.Department of Haematology/OncologyMartin-Luther-University Halle-WittenbergHalleGermany
  4. 4.Department of UrologyMartin-Luther-University Halle-WittenbergHalleGermany
  5. 5.Department of Medical Statistics and ControllingMartin-Luther-University Halle-WittenbergHalleGermany

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