• ac-adenocarcinoma
• esophageal cancer (ec)
• esophagus adenocarcinoma
• gastroesophageal adenocarcinoma
• gastroesophageal cancer
• gastroesophageal junction (gej)
• muscle metastasis
• rare metastasis
• skeletal muscle metastasis

• contrast-enhanced ultrasonography
• hepatocellular carcinoma
• moderately differentiated
• muscular metastasis
• teres major muscle

• Aged
• Carcinoma, Hepatocellular/diagnostic imaging
• Contrast Media
• Humans
• Image Enhancement
• Liver Neoplasms/diagnostic imaging
• Male
• Ultrasonography

• Metastatic esophageal cancer
• Soft tissue metastases

The most common pattern of esophageal cancer metastases (ECM) is to the lymph nodes, lung, liver, bones, adrenal glands, and brain. On the other hand, unexpected metastasis (UM) spread to uncommon sites has increasingly reported and consequently affected the pathway of diagnosis, staging, and management. Using the PubMed database, a systematic search of the following headings “Esophageal” and “Metastasis” or “Metastases” was performed, 10049 articles were identified, and the articles were included if they demonstrated unexpected ECM. 84% of cases were men with an average age of 60.7 years. EC was located in the lower third in 65%. Two-thirds of the UM originated from the lower esophagus, and the two major histological types were adenocarcinoma 40% and squamous cell carcinoma 60%. Metastases were disseminated toward five main anatomical sites: the head and neck (42%), thoracic (17%), abdomen and pelvis (25%), extremities (9%), and multiple skin and muscle metastases (7%). The EC metastases were found to be synchronous 42% and metachronous 58%, isolated in 53.5% and multiple in 46.5%. The overall survival rate was 10.2 months. Since distant metastases are responsible for most EC-related deaths, understanding of ECM dissemination patterns needs more extensive studies. These critical data are the cornerstone of optimal cancer approach and treatment.

• Esophageal adenocarcinoma
• neoplasm metastasis
• signet ring cell (SRC)
• skeletal muscle

To investigate the magnetic resonance imaging (MRI) features of skeletal muscle metastases (SMM).

The records of 31 patients with proven SMM were retrospectively reviewed. Clinical history, type of primary malignancy, location of metastases, and MRI features of SMM were evaluated. Based on MRI findings, SMM were divided into three MRI types. The correlation between MRI types with ages and pathology category, between MRI types of SMM and ages, as well as MRI types of SMM and pathology category were analysed with Spearman's rho.

The most common primary tumour was genital tumour (25.8%) and bronchial carcinoma (19.4%), and the most common cell type was adenocarcinoma (58.1%). SMM were located in the iliopsoas muscle (26.3%), paravertebral muscles (21.1%), and upper extremity muscles (18.4%). MRI features: (1) Type-I localised lesions (12.90%), round-like mass limited to local regions with heterogeneous iso-signal intensity in T1WI and heterogeneous hyper-intensity in T2WI; (2) Type-II diffuse lesions without bone destruction (35.48%), abnormal diffuse swelling of the muscle with irregular boundaries and slightly hypo- to iso-intensity in T1WI and hyper-intensity in T2WI; and (3) Type-III diffuse lesions with bone destruction (51.61%), distinct irregular lump with iso-intensity in T1WI and heterogeneous hyper-intensity in T2WI with adjacent bone invasion. There was positive correlation between MRI types and ages (r = 0.431, p < 0.05). There were no significant differences of MRI types with pathology category (p > 0.05).

SMM features on MRI can be broadly used to classify lesions, which is beneficial for SMM diagnosis.

• MRI
• metastases
• skeletal muscle
• tumour

• Carcinomatosis
• Infiltrative
• MRI
• Metastasis
• Muscle

• Cáncer esófago
• Metástasis muscular
• Metástasis subcutánea
• Muscle metastasis
• Oesophageal cancer
• PET-TAC (18)F-FDG
• PET/CT (18)F-FDG
• Subcutaneous metastasis

• Adenocarcinoma/diagnosis
• Adenocarcinoma/pathology
• Esophageal Neoplasms/diagnosis
• Esophageal Neoplasms/pathology
• Humans
• Male
• Middle Aged
• Neoplasm Metastasis

• Positron emission tomography/computed tomography (PET/CT)
• skeletal muscle metastases

Carcinoid tumors are rare but diverse group of malignancies that arise from neuroendocrine cells. Skeletal muscle metastasis is exceedingly rare and is associated with a poor prognosis. We report a case of carcinoid tumor of the ileocecal with skeletal muscle metastasis. We also review available case reports of carcinoid tumors metastasizing to the muscle.

• Carcinoid tumor
• Muscle metastasis
• Neuroendocrine tumor

Metastases of esophageal carcinoma to the skeletal muscle are rare, but the incidence may be increasing because of better diagnosis resulting from widespread use of positron emission tomography/computed tomography (PET/CT). A cohort of 205 patients with esophageal carcinoma treated at our center who had PET/CT between 2006 and 2010 was retrospectively evaluated for the presence of skeletal muscle metastases. Four patients had skeletal muscle metastases of esophageal carcinoma, including two patients with squamous cell carcinoma. In another patient with squamous cell carcinoma of the esophagus and synchronous skeletal muscle metastases, muscle metastases were subsequently shown to be related to second primary pancreatic adenocarcinoma. In all cases, skeletal muscle metastases were the first manifestation of systemic disease. In three patients palliation was obtained with the combination of external beam radiation therapy, systemic chemotherapy or surgical resection. Skeletal muscle metastases are a rare complication of esophageal carcinoma.

• Drug therapy
• Esophageal neoplasms
• Muscle
• Skeletal
• Positron-emission tomography
• Radiotherapy

Soft tissue metastases are an uncommon presenting feature for primary solid tumours. This case highlights a rare presentation in which a soft tissue mass is the first clinical manifestation of a widespread disseminated malignancy of the esophagus. A 73-year-old woman presented with a soft swelling in the left upper quadrant of the abdomen arising from the anterior abdominal wall, suspicious of liposarcoma. Core biopsies revealed squamous carcinoma. Immunohistochemistry suggested the most likely diagnosis was that of metastatic carcinoma with a number of potential primary sites. Computed tomography scanning showed widespread metastatic disease, including lung, liver, kidney, omentum, subcutaneous and intramuscular lesions. The distal esophagus was noted to be circumferentially thickened. Finally, upper gastrointestinal endoscopy revealed carcinoma of the esophagus. The patient remains well awaiting esophageal stenting and palliative chemotherapy. In conclusion, it is important to be able to distinguish the origin of a soft-tissue swelling as the management will depend significantly on the histological type. Soft-tissue metastases are rarely encountered as a presenting sign of an occult cancer. Primary cancers that most commonly metastasise to soft tissues include those arising within the lung, colon and kidney. The most frequent histological diagnosis is adenocarcinoma. This case demonstrates the utility of biopsy in the investigation of soft tissue masses when the clinical presentation is unusual.

• Biopsy
• Esophagus
• Occult cancer
• Soft tissue metastasis
• Squamous cell carcinoma