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Case Report

Unusual skeletal muscle metastasis from carcinoma cervix

Mehlam Kausar , Desh Deepak Ladia , Abhinav Mutneja , Virendra Bhandari 2
1
1
1
1 Department of Radiation Oncology, Sri Aurobindo Institute of Medical Science, Indore 452008, Madhya Pradesh, India.
2 Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore 452008, Madhya Pradesh, India.
Correspondence to: Dr. Virendra Bhandari, Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore
452008, Madhya Pradesh, India. E-mail: virencancer@yahoo.co.in
Dr. Virendra Bhandari, MD in Radiation Oncology, has worked as Senior Registrar at TMH, Mumbai and then as
Consultant Oncologist at Allahabad and Aurangabad, and treated solid and haematological malignancies. He has been
trained in Brachytherapy, Hyperthermia, IGRT, SRT, and SBRT at Christie Hospital Manchester(UK), Utrecht Hospital
and DD Hoed Hospital, The Netherlands, Henry Ford Hospital, Detroit & FROG’s Clinics, Jacksonville, USA and
Humanitas Hospital, Milan, Italy. Presently he is working Professor at Sri Aurobindo Medical College and P G Institute,
Indore. He has 35 Publications in Indexed journals to his credit.

A B S T R AC T
Cervical cancer is the most common malignancy in Indian women. It usually spreads locally or via regional lymphatics to retroperitoneal
lymph nodes and hematogenous spread is rare. The occurrence of skeletal muscle metastases is a very rare event and only a few cases
have been reported in literature. The authors present an unusual case of cervical carcinoma in a patient that presented with skeletal muscle
metastasis 1 year after the treatment.
Key words: Cervix; skeletal muscle; unusual metastasis

INTRODUCTION per vagina for 3 months. On local examination, cervix
was completely destroyed by a proliferative growth
Metastasis of carcinoma cervix to skeletal muscles is a rare involving both the right and left fornix and the lower third
occurrence. Muscles are highly resistant to primary and of the vagina. Both the right and left parametrium were
metastatic cancer due to their high contractile activity, local indurated to the lateral pelvic wall. Ultrasonography of the
changes in pH, oxygenation, accumulation of metabolites, abdomen was suggestive of 8.6 cm × 5.3 cm large solid
blood flow, and local temperature. Psoas, iliopsoas, heterogeneous mass with scattered calcification in the
[1]
paraspinal muscles, and proximal musculature of the upper cervical region. Histopathology from the growth revealed
and lower limbs, represent the most frequently involved moderately differentiated squamous cell carcinoma.
sites. Malignancies known to metastasize frequently to Metastatic workup did not show any metastatic lesion in
the muscle are melanoma, kidney, lung, thyroid cancer, liver or lungs. Thus, a diagnosis of carcinoma cervix IIIb
lymphoma, leukemia and colon cancer. We report a (Federation of Gynecology and Obstetrics stage) was made.
[2]
case of carcinoma cervix with metastasis to paraspinal Then, the patient was planned for concurrent chemotherapy
and intercostal skeletal muscle as the initial sign of and radiotherapy. She was given radical radiotherapy to
dissemination.
the whole pelvis with external beam radiotherapy to a dose
CASE REPORT of 60 Gy/30 over a period of 6 weeks. She also received
6 cycles of weekly cisplatin concurrently (30 mg/m
2
A post-menopausal female, married for 45 years with two intravenous). Intracavitary boost was not given as both the
children, presented with a complaint of white discharge
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How to cite this article: Kausar M, Ladia DD, Mutneja A, Bhandari V.
Unusual skeletal muscle metastasis from carcinoma cervix. J Cancer
DOI: Metastasis Treat 2016;2:67-9.
10.4103/2394-4722.170545
Received: 02-03-2015; Accepted: 26-10-2015.

© 2016 Journal of Cancer Metastasis and Treatment ¦ Published by OAE Publishing Inc. 67