MUSCULAR METASTASIS AS THE FIRST MANIFEST ATION OF AN ADENOCARCINOMA

The authors report the case of a 67-year old man, with no particular m edical history, presenting a large swelling of the left thigh. Investi gations conclude to metastases located in muscles of the left thigh an d of the pelvis, secondary to an adenocarcinoma of presumed pancreatic origin. With reference to this case, features of muscular metastases are reviewed. Muscular metastases seldom occur during the course of a cancer and are exceptionally the first manifestation of a neoplastic p rocess. They are usually described as a painful mass, but symptoms can be misleading and delay diagnosis. Images obtained by ultrasonography , tomodensitometry and magnetic resonance imaging are not specific and histological examination is necessary to confirm the diagnosis.