Multiple skeletal muscle metastases revealing a cardiac intimal sarcoma


We report the case of a 59-year-old female with progressive bilateral painful swelling of the thighs. MRI revealed multiple intramuscular necrotic masses with similar morphologic patterns. Whole-body CT and 18-FDG PET-CT scans demonstrated additional hypermetabolic muscular masses and a lobulated lesion within the left atrial cavity. As biopsy of a muscular mass was compatible with a poorly differentiated sarcoma with MDM2 oncogene amplification, two diagnoses were discussed: a dedifferentiated liposarcoma with muscle and heart metastases or a primary cardiac sarcoma, mainly a cardiac intimal sarcoma, with muscular metastases, which was finally confirmed by array-comparative genomic hybridization (aCGH) in a sarcoma reference center. This case emphasizes the potential for intimal sarcoma to disseminate in skeletal muscle prior to any other organ and the need for a genomic approach in addition to classical radiopathologic analyses to distinguish primary from secondary locations facing simultaneous tumors of the heart and skeletal muscles with MDM2 amplification.

DOI: 10.1007/s00256-017-2768-5

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@article{Cromb2017MultipleSM, title={Multiple skeletal muscle metastases revealing a cardiac intimal sarcoma}, author={Amandine Cromb{\'e} and Pierre-François Lintingre and François Le Loarer and Denis Lachatre and Benjamin Dallaudi{\`e}re}, journal={Skeletal Radiology}, year={2017}, pages={1-6} }