Japanese Journal of Radiology

, Volume 32, Issue 3, pp 164–171 | Cite as

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

  • Marialuisa Bocchino
  • Tullio Valente
  • Francesco Somma
  • Ilaria de Rosa
  • Marco Bifulco
  • Gaetano Rea
Original Article



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.


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.


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.


Lung cancer Skeletal muscle metastases Multi-detector computed tomography Ultrasonography Positron emission tomography 


Conflict of interest



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Copyright information

© Japan Radiological Society 2014

Authors and Affiliations

  • Marialuisa Bocchino
    • 1
    • 6
  • Tullio Valente
    • 2
  • Francesco Somma
    • 3
  • Ilaria de Rosa
    • 4
  • Marco Bifulco
    • 5
  • Gaetano Rea
    • 2
  1. 1.Respiratory Medicine Section, Department of Clinical Medicine and Surgery“Federico II” University of NaplesNaplesItaly
  2. 2.Radiology Operative Unit, Department of Imaging DiagnosticsMonaldi HospitalNaplesItaly
  3. 3.Department of Radiology “Magrassi Lanzara”Second University of NaplesNaplesItaly
  4. 4.Department of PathologyMonaldi HospitalNaplesItaly
  5. 5.Nuclear Medicine Operative Unit, Department of Imaging DiagnosticsMonaldi HospitalNaplesItaly
  6. 6.Ospedale MonaldiNaplesItaly

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