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12 June 2019 : Case report  USA

Spindle Cell Sarcoma of the Paraspinal Musculature with Late Pulmonary Metastases

Diagnostic / therapeutic accidents, Rare disease

Austin H. Allen1ABCDEF*, Ashley C. Gullixson1ABCDEF

DOI: 10.12659/AJCR.915602

Am J Case Rep 2019; 20:828-832

Abstract

BACKGROUND: Sarcomas account for less than 1% of all cancers. Spindle cell sarcomas are a rare form of soft tissue sarcomas classified as undifferentiated/unclassified based on their histomorphology. These tumors have a propensity for local recurrence and distant metastases are frequently found in the lungs. The risk for metastases increases with higher-grade malignancy and the size of the primary tumor. The often-painless nature of these tumors results in a delay in diagnosis, and physicians frequently overlook sarcomas in their differentials due to their rarity, complicating the disease process.

CASE REPORT: This article reports a case of a spindle cell sarcoma in the left paraspinal musculature in a 58-year-old Caucasian male; the tumor was excised in large pieces. There was an initial benign course, during which time the patient was undergoing regular imaging studies to evaluate for recurrence. Eight years later, the tumor metastasized to the lungs with an initial presentation of shortness of breath and pleural effusion on imaging.

CONCLUSIONS: Sarcomas are very rare soft tissue neoplasms, but they should not be overlooked in a physician’s differentials, especially when evaluating an enlarging mass. Recommended treatment of choice is complete surgical excision with adequate resection margins of at least 1 cm or greater to a fascial barrier. Recurrence and late pulmonary metastases are common and metastatectomy is the recommended treatment choice if metastases are present.

Keywords: metastasectomy, Neoplasm Metastasis, Sarcoma, Soft Tissue Neoplasms, Chemotherapy, Adjuvant, Follow-Up Studies, Lung Neoplasms, Magnetic Resonance Imaging, Middle Aged, Muscle Neoplasms, Neoplasm Invasiveness, Neoplasm Staging, Paraspinal Muscles, Radiotherapy, Adjuvant, Risk Assessment, Treatment Outcome

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923