Skeletal muscle metastasis from colorectal adenocarcinoma: A literature review

Table 1 Characteristics of case reports of skeletal muscle metastasis in colorectal adenocarcinoma

Case	Ref.	Age/sex	Site of primary tumour	Presenting symptom	Surgery of primary tumour	Histology of primary	Site of skeletal metastasis and treatment	Non-skeletal metastases	Time interval in mo	Follow-up/outcome
1	Hasegawa et al[14], 2000	60/M	Transverse colon	Not described	Transverse colon resection and lymph node dissection + FOLFOX	Adenocarcinoma	Right extensor carpi ulnaris muscle; a major part of the right extensor carpi ulnaris and the extensor digiti minimi muscle were resected, warranting a sufficient margin of 5 cm of normal tissue from the tumour	Multiple hepatic metastases detected 14 mo after primary resection and was resected	24	Alive
2	Buemi et al[3], 2019	69/F	Right colon	Pain when mobilizing left leg + elevated CEA of 7.7 ng/mL	Right hemicolectomy	pT3N0M0 (0/44 lymph nodes)	Left gluteus muscle; lesion was resected en bloc		7	Alive; 6 yr after colectomy and 65 mo after resection of the muscular metastasis she was tumour free with normal CEA level
3	Yi et al[17], 2015	67/M	Caecum	Swelling and pain	Right hemicolectomy and subsequent chemotherapy with a regimen containing oxaliplatin	Poorly differentiated	Right thenar muscles	Liver, right kidney, right abdominal wall, left axillary and right subclavicular lymph nodes, skin of right thigh; treatment was given with palliative systemic chemotherapy (FOLFIRI)	Synchronous	Dead (9 mo after diagnosis)
4	Araki et al[18], 1994	66/M	Ascending colon	Painful lump	Right hemicolectomy		Right teres major; excision of the mass was performed		6	Dead (31 mo after surgery)
5	Manafi-Farid et al[19], 2019	23/M	Rectum	Incidentally detected in FDG-PET studies	Proctocolectomy preceded by neoadjuvant chemotherapy and followed by adjuvant chemotherapy, including the FOLFOX regimen	pT3N1	Multiple: Deltoid, external oblique, biceps, tongue; excisional biopsy of the deltoid muscle lesion proved to be metastatic adenocarcinoma; commenced chemotherapy (FOLFIRI)	Lung/adrenal gland/scalp	24	Alive
6	Torosian et al[20], 1987	69/M	Transverse colon		Extended right colectomy		Left thigh; en bloc resection was performed		60	Not specified
7	Okada et al[21], 2009	70/M	Rectum	Painful lump	Rectal resection		Right thigh; resection and chemotherapy were given	Lung	12	Alive; the resection of SMM made a positive contribution to his quality of life
8	Chang et al[22], 1994	62/M	Descending colon	Painful lump			Left tibialis anterior; excision of the mass was performed		Synchronous	Not specified
9	Yoshikawa et al[23], 1999	54/M	Sigmoid colon	Severe buttocks pain	Partial sigmoid colectomy		Right buttocks; en bloc resection performed	Multiple metastases	24	Died after 8 mo from multiple metastases
10	Guo et al[16], 2021	43/M	Ascending colon	Right thigh mass 4 cm × 4 cm with intolerable pain	Laparoscopic extended right hemicolectomy and four cycles of chemotherapy with CapeOX	PT4N2bM0; poorly differentiated adenocarcinoma	Right thigh; a complete resection was suggested but was refused by the patient; unresponsive to FOLFIRI; switched to bevacizumab, irinotecan, and capecitabine	Bony metastasis and multiple lymph node metastases around the abdominal aorta	5	Deteriorated and died 9 mo after primary resection
11	Tatsuta et al[24], 2022	83/M	Ascending colon	Pain in the back of his neck	Curative resection	Adenocarcinoma	Cervical (neck muscle); he was prescribed palliative radiation therapy because of his poor performance status	None	11	Died 2 mo after diagnosis of muscle metastasis
12	Iusco et al[25], 2005	73/F	Ascending colon	Painful lump	Right hemicolectomy	Dukes C	Left calf; the mass was excised and received adjuvant radiotherapy	None	24	Alive; no sign of recurrence at a 2-yr follow-up
13	Landriscina et al[9], 2013	71/F	Right colon	Detected on PET/CT scan	Right hemicolectomy with subsequent systemic neoadjuvant chemotherapy for liver metastasis followed by radical hepatectomy	Poorly differentiated adenocarcinoma	Deltoid, sternocleidomastoid and other multiple sites; chemotherapy with FOLFOX was administered for 3 cycles but discontinued due to traumatic femur fracture	Liver/lung	23	Disease progression and death
14	Hattori et al[26], 2008	64/F	Rectum	Asymptomatic; increased CEA; discovered by FDG-PET	Abdominoperineal rectal resection	Moderately differentiated adenocarcinoma	Right thoracic paraspinal muscles; en bloc excision was performed including the paraspinal muscles	Solitary lung metastasis, which was resected 3 yr previously by lobectomy with subsequent immunochemotherapy	96	Alive
15	Choi et al[27], 2008	83/F	Rectum	Painful lump	Low anterior resection and right liver lobectomy	T2N1M1	Semimembranous muscle of right thigh	Solitary pulmonary nodule in left lobe	48	Died of heart failure on second postoperative day
16	Doroudinia et al[28], 2019	48/M	Rectum	Subcutaneous lump	Abdominoperineal rectal resection followed by adjuvant radiotherapy and chemotherapy	High grade mucinous adenocarcinoma	Right proximal thigh; the patient became a candidate for tumour excision (metastasectomy) followed by additional course of chemotherapy.	None	38	Not specified
17	Tunio et al[29], 2013	28/M	Transverse colon	Abdominal pain and hard nodule at anterior abdominal wall	Extended right hemicolectomy; radiotherapy; FOLFOX4	Mucinous moderately differentiated adenocarcinoma T4N2bM0	Rectus abdominis muscle and right gluteus maximus; underwent palliative radiotherapy followed by systemic chemotherapy	None	11	Alive at time of publication with progressive disease
18	Simeunovic et al[30], 2014	55/F	Rectum	Lower back pain and left hip pain as first manifestation of the primary tumour	Radiotherapy; chemotherapy with FOLFOX	Poorly differentiated adenocarcinoma	Left adductor muscle	None	Synchronous	Not specified
19	Prabhu et al[31], 2017	69/M	Rectum	Severe low back ache	Neoadjuvant; abdominoperineal resection; capecitabine	Adenocarcinoma with signet ring cell features T3N2; Dukes C1	Multiple skeletal muscles: left sartorious, left vastus lateralis, left infraspinatus, left levator scapulae, left tenth Intercostal muscle, right subscapularis muscle	None	4	Not specified
20	Tai et al[32], 2014	81/M	Caecum	Severe right shoulder pain	Palliative chemotherapy; palliative right hemicolectomy	Poorly differentiated adenocarcinoma	Right supraspinatus muscle	Right lobe of lung	Synchronous	Patient transitioned to hospice
21	Farraj et al[33], 2021	52/F	Rectum	Noted with preoperative staging	Low anterior resection; adjuvant combination of oxaliplatin, capecitabine, and pelvic external beam radiation therapy	Moderately differentiated adenocarcinoma T2N1a	Left psoas muscle	None	Synchronous	Patient is currently maintained on platinum doublet chemotherapy with control of metastatic disease
22	Salar et al[34], 2012	67/F	Rectum	Deep pelvic and left buttock pain	EUA; submucosal polypectomy	Tubullovillous adenomatous polyp with high grade dysplasia	Left piriformis muscle	None	18	Patient began cycles of chemoradiotherapy with plans for further surgical resection
23	Homan et al[35], 2000	72/F	Descending colon		Surgical resection; FOLFOX		Thigh			NA
24	Takada et al[36], 2011	71/M	Sigmoid colon		Radiotherapy; FOLFOX; resection “Hartmann”	Stage III adenocarcinoma	Left iliopsoas muscle; received radiotherapy and 15 courses of FOLFOX + bevacizumab for decreasing large and unresectable tumour; then resection was performed	GI metastasis	60	5 mo after resection of muscle metastasis, there was no recurrence
25	Naik et al[37], 2005	56/M	Ascending colon	A lump	Resection; chemotherapy FOLFOX; radiotherapy	Mucin secreting adenocarcinoma	Rectus abdominis muscle; resection was performed	NA	60	Not specified
26	Burgueño Montañés and López Roger[38], 2002	60/M	Rectosigmoid	Exophthalmos	Radiotherapy; FOLFOX		Lateral rectus muscle			Not specified
27	García-Fernández et al[39], 2012	32/M	Colon	Palpebral oedema, conjunctival chemosis, severe exophthalmos, complete ptosis in left eye and limitation in eye movement mainly in abduction and supraversion	Resistant to chemotherapy	Stage IV	Superior rectus elevator muscle of upper eyelid complex and external rectus muscle			Due to the patient generally feeling unwell, radiotherapy was not considered, and an intravenous bolus of corticoids was given, without response, resulting in the death of the patient
28	Lampenfeld et al[40], 1990	75/F	Rectum	Progressive growth of left buttock mass	Excision of mass	Adenocarcinoma	Left gluteus maximus and medius		24
29	Laurence and Murray[41], 1970; Case 1	70/F	Caecum	Painful mass in posteroexternal aspect of right calf and leg oedema	Right hemicolectomy	Ulcerated villous adenocarcinoma	Right calf; en bloc resection was performed	Generalized metastasis	24	Died due to generalized metastasis
30	Laurence and Murray[41], 1970; Case 2	51/M	Transverse colon		Right colectomy		Right forearm; en bloc resection was performed	Generalized metastasis	Synchronous	Died due to generalized metastasis

CapeOX: Combination of capecitabine and oxaliplatin; CEA: Carcinoembryonic antigen; EUA: Examination under anaesthesia; F: Female; FDG-PET: Fluorodeoxyglucose positron emission tomography; FOLFOX: Combination of folinic acid, 5-fluorouracil and oxaliplatin; FOLFOX4: Combination of 5-fluorouracil, leucovorin and oxaliplatin; FOLFIRI: Combination of leucovorin, 5-fluorouracil and irinotecan; GI: Gastrointestinal; M: Male; NA: Not available; PET/CT: Positron emission tomography computed tomography; SMM: Skeletal muscle metastasis.