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Case Reports
. 2017 Aug 4;10(2):694-698.
doi: 10.1159/000478976. eCollection 2017 May-Aug.

Solitary Skeletal Muscle Metastasis as First Site of Recurrence of Cervical Cancer: A Case Report

Indumathy Varadarajan  1 , Aparna Basu  2 , Sherri Besmer  1 , Jaganmohan Poli  3 , Scott Richard  4 , Michael Styler  1
Affiliations
Case Reports

Solitary Skeletal Muscle Metastasis as First Site of Recurrence of Cervical Cancer: A Case Report

Indumathy Varadarajan et al. Case Rep Oncol. .

Abstract

Cervical cancer is the fourth most common cancer in women worldwide, with a large majority of prevalence (85%) in developing countries. As of 2012, it accounts for 7.5% of all female cancer deaths. Despite its high prevalence, skeletal muscle metastasis from cervical cancer is extremely uncommon. In our extensive literature search, we were able to find only 8 cases where skeletal muscle metastasis was the only site of recurrence. We report a case of a 52-year-old African-American woman with a past medical history of cervical cancer (stage IIIB) who presented with pain and swelling in her left upper arm over the preceding 2 months. MRI of the left upper arm showed a solid well-circumscribed mass measuring 7.0 × 2.8 × 2.5 cm, deep to the biceps. Biopsy of the mass revealed a metastatic squamous cell carcinoma that was p16-positive. PET scan showed that the lesion was the sole site of metastasis. She received local radiation with concurrent chemotherapy. Follow-up MRI 6 months after the completion of therapy showed resolution of the mass. She has remained disease-free for the last 24 months as evidenced by a PET/CT scan in May 2016. In this case report, we discuss the role of imaging and pathology in the diagnosis of a solitary metastatic lesion. This case also emphasizes the importance of a close follow-up which aids in early intervention, increasing overall survival.

Keywords: Cervical cancer; Gynecological cancer; Human papillomavirus; Metastasis; Musculoskeletal metastasis; Solitary metastasis.

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Figures

Fig. 1
Fig. 1
Pretreatment MRI (December 2014). Contrast-enhanced T1-weighted images with sagittal and coronal section.
Fig. 2
Fig. 2
Posttreatment MRI (September 2015). Coronal and sagittal section.
Fig. 3
Fig. 3
Nests of malignant squamous cells within a background of mostly fibrous tissue with atrophic muscle and chronic inflammation (right panel). The malignant squamous cells demonstrate strong and diffuse positivity for p16 immunohistochemical stain (left panel).
See this image and copyright information in PMC

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