ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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Metastasis Of Squamous Cell Carcinoma Into Soft Tissue
Dr.Sevgiye KAÇAR ÖZKAR,a Dr.Nedim ÖZKARA,b Dr.Murat HIZ,c Dr.Cengiz ERÇİNa
aPatoloji AD, Kocaeli Üniversitesi Tıp Fakültesi,
bSSK Gebze Hastanesi, KOCAELİ
cOrtopedi ve Travmatoloji AD, İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, İSTANBUL
Metastasis of squamous cell carcinoma into soft tissues is rarely observed. The clinical diagnosis of these metastases –if the primary tumor was not identified- would generally be sarcoma, and before bony invasion, open biopsy is generally needed in order to diagnose them correctly. A metastatic squamous cell carcinoma of soft tissue diagnosed by fine needle aspiration cytology is presented in this report.
A fifty-five year-old male patient presented with intense pain at his left posterior cruris for 3 months. On physical examination, a firm, fixated mass lesion of about 5x10 cm in the gastrocunemius muscle at the left cruris that limited the range of motion at the ankle joint was detected. Radiologic examination revealed a soft tissue mass with central necrosis extending from the superficial dermis to the bone, infiltrating the musculus gastrocunemius-soleus, but the bone was intact. Fine needle aspiration biposy was performed and was interpreted as metastatic squamous cell carcinoma. Follow-up incissional biopsy confirmed the same diagnosis. Total body scintigraphy was performed to investigate the possible deposits, but no ‘hot spot’ other than the crural lesion was detected. Computerized tomography of the lungs revealed a 5 cm cavitary mass lesion. The lung lesion was thought to be the primary and fine needle aspiration biopsy was offered to the patient. The patient refused any diagnostic procedure to the lungs, whereupon wide resection to the crural tumoral mass was carried out. Tumoral infiltration affecting dermis, subcutaneous tissue and striated muscle was observed. Lymphatic and vascular as well as perineural invasion were present. The patient received radiotherapy postoperatively, but died after 6 months with symptoms localizing pulmonary involvement.
This case is presented because of its rarity, difficulty in its diagnosis and uncertainity about its optimum treatment and follow-up.Keywords: Soft tissue, subcutaneous, intramuscular, metastasis, carcinomaTurkiye Klinikleri J Med Sci 2004, 24:189-192
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