Soft tissue metastases are uncommon and can easily be clinically and histopathologically confused with primary soft tissue sarcomas. The prevalence of soft tissue metastases varies in autopsy series from 6 to 17.5 % and in radiological series from 1.2 to 1.8 % 15,. The lung, skin, kidney, and colon are the most common sites of primary carcinomas.
The thigh muscles, iliopsoas, and paravertebral muscles are the most frequent affected sites. The time interval between primary tumor detection and metastasis is extremely variable.
Radiographs and CT are not ideal methods for characterization of soft tissue metastasis. In some cases, calcifications within the soft tissue masses can be recognized especially in pancreatic, gastric carcinoma and osteosarcoma metastases. Soft tissue metastases are particularly amenable to high-resolution color Doppler ultrasound examination. In most cases, they appear as well-circumscribed hypoechoic and hypervascularized masses.
On MRI, soft tissue metastases are of low or intermediate signal intensity compared to normal muscle tissue on T1-weighted sequences and high signal intensity on T2-weighted sequences. 18F-FDG PET/CT was demonstrated to have a higher sensitivity compared with MRI in detecting soft tissue metastases. 18F-FDG PET/CT imaging may reveal the primary tumors of the soft tissue metastasis, which is helpful for differential diagnosis.
After appropriate imaging, early percutaneous biopsy is recommended. It is advocated to biopsy unique, solitary, or late metastases and in case of unknown primary tumor. Biopsy is not recommended in case of a disseminated disease.
High Signal Intensity Myositis Ossificans Intermediate Signal Intensity Soft Tissue Metastasis Unknown Primary Tumor
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