Metastatic non-small cell lung carcinoma with involvement of extremity musculature: Case report and review of the literature

Hematogenous dissemination of non-small cell lung carcinoma (NSCLC) metasta tic to skeletal musculature in the absence of osseous involvement is an inf requent occurrence. We retrospectively reviewed our institution's indexed d atabase for patients evaluated from 1975 through 1997 who were diagnosed as having skeletal musculature metastases from NSCLC, Eight men and 2 women w ere identified (age range, 51-80 years at time of metastases), Four primary adenocarcinomas, 4 primary lung squamous cell carcinomas (SCCs), and 2 poo rly differentiated primary NSCLCs were identified. Approximate tumor sizes ranged from 10 cm(3) to 288 cm(3). External-beam radiation therapy was used in 7 of 10 cases; complete surgical excision was performed in 3 cases. Pat ients with known neoplasm who have extremity pain and negative findings on bone scan should be evaluated for soft tissue tumor involvement because suc h findings significantly affect clinical management. One case of lung SCC m etastatic to the quadratus femoris muscle in a 63-year-old man is discussed in detail.