Skeletal muscle metastasis from malignant melanoma

doi:10.1016/j.bjps.2004.12.001

British Journal of Plastic Surgery

Volume 58, Issue 6, September 2005, Pages 855-858

https://doi.org/10.1016/j.bjps.2004.12.001 Get rights and content

Summary

Malignant melanomas commonly metastasise to skin, subcutaneous tissue and lymph nodes. Skeletal muscle metastases from malignant neoplasms are uncommon. There have been very few reports of malignant melanoma metastasising to skeletal muscle. We report a case of malignant melanoma metastasis in the thigh musculature in a young female patient.

Section snippets

Case history

A 41-year-old female presented with a pigmented smooth nodular lesion of 3 mm diameter on her right forearm (Fig. 1), which had darkened in colour. She had also noticed a painless lump in her right axilla, which clinically was an enlarged node. An excision biopsy of the pigmented lesion was performed. Histology showed this to be a malignant melanoma with Breslow thickness of 1 mm and Clarkes level III. The cells were strongly positive for S-100, weakly positive for Melan A, positive for NK1,

Discussion

Melanomas can metastasise to any organ. The first sign of spread is usually in the distant skin, subcutaneous sites and lymph nodes followed by lungs, liver, brain, bone and intestine. Multiple organ metastases are reported in 95% of patients dying from melanoma.1, 18 Although, direct invasion of muscle by carcinoma is well recognised, the incidence of metastatic tumours in muscle is low.²

The commonest tumours metastasising to skeletal muscle are carcinomas of the lung, kidney, colon,³

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Complications of intramuscular metastasis in a patient with lung cancer
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The incidence of skeletal muscle metastases is reported to be less than 1% of metastases of haematogenous origin. Distant skeletal muscle metastases from head and neck squamous cell carcinomas are exceedingly rare. Only a case with tongue carcinoma metastasized to paravertebral muscles, has been reported so far. The reasons for the rarity of metastatic involvement of skeletal muscle are still unclear. The presence of skeletal muscle metastases in the setting of disseminated disease offers no hope for curative treatment. We report an unusual case of a 63-year-old patient with tongue carcinoma metastasizing to the left shoulder muscles. To our knowledge, this is the first such case to be reported in the English medical literature.
Atypical late presentation of muscular metastasis of melanoma in the contralateral limb
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Case ReportSkeletal muscle metastasis from malignant melanoma

Summary

Section snippets

Case history

Discussion

Br J Plast Surg

Br J Plast Surg

Med Hypotheses

An analysis of the prognostic factors in 8500 patients with cutaneous melanoma

Neuromuscular disorders associated with malignant disease

Distant soft tissue metastases: a series of 30 new patients and 91 cases from literature

Ann Surg Oncol

Metastasis of malignant neoplasms of skeletal muscle

Rev Esp Oncol

Metastatic carcinoma to skeletal muscle—a report of 15 patients

Clin Orthop

A case of melanotic sarcoma

Trans Pathol Soc Lond

Case Report
Skeletal muscle metastasis from malignant melanoma