Soft tissue metastases in lung cancer: a review of the literature

C. Perisano, M.S. Spinelli, C. Graci, L. Scaramuzzo, E. Marzetti, C. Barone, C. Fabbriciani, G. Maccauro

Department of Orthopaedics and Traumatology and Division of Medical Oncology, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy. carloperisano@hotmail.it

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• Oncology

Background: In lung cancer patients, metastases to soft tissues (STs), including skeletal muscle, subcutaneous tissue and skin, are rarely reported. Besides, lung cancer, primary carcinomas of the kidney and colon are the most commonly associated with ST metastases.

AIM: To determine the prevalence, clinical-pathological features and treatment options of ST metastases originating from lung carcinoma.

MATERIALS AND METHODS: A literature search was performed using the following terms: lung cancer, ST metastasis, skeletal muscle metastasis, cutaneous metastasis, subcutaneous metastasis.

RESULTS: Autopsy series have detected STs metastases in 0.75-9% of patients who died from metastatic lung carcinoma. Pain and the presence of a palpable mass are the most frequent clinical features. The biopsy is recommended after MRI for diagnosis. Due to the rarity of ST metastases, the differential diagnosis must be posed especially with primary ST sarcomas. The type of treatment depends on the patient’s clinical status and prognosis, and includes observation, radiotherapy, chemotherapy and surgery.

CONCLUSIONS: In lung cancer patients, ST metastases are rare, but not exceptional. Their presence should be suspected in the presence of a palpable mass either painful or asymptomatic. Radiological and histological examinations are required for the definite diagnosis. The choice of treatment should be based on considerations related to the stage of the primary tumor and the patient’s global health status.

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