[120] The Prognostic Significance of Sarcoma Metastases to Skin

W-L Wang, RA Bones Valentin, DC Lev, VG Prieto, AJ Lazar. The University of Texas M.D. Anderson Cancer Center, Houston, TX

Background: Sarcoma metastases to skin are relatively rare as most metastases involve lung, liver or deeper soft tissues. Here we examine the distribution and clinical significance of cutaneous and superficial subcutaneous sarcoma metastases.
Design: 65 patients with histologically confirmed dermal and superficial subcutaneous sarcoma metastases were identified in pathology files from more than 25,000 sarcoma patients evaluated at M. D. Anderson (1989-2009). Pathology slides, clinical and radiologic information were evaluated.
Results: Cutaneous metastases were histologically documented in less than 0.25% of more than 25,000 sarcoma patients. The mean patient age was 49 years (16-79) with equivalent gender ratio. The most common source was leiomyosarcoma (28/65, 43%; see Table 1). The most common region of first skin metastasis was head and neck (33, 51%) with the scalp predominating (25,38%). Mean time from primary tumor diagnosis to skin metastasis was 48 months (0-166). 53 patients (81%) had multiple metastases (skin & other). In patients with complete clinical information available, 31 (62%) had other metastases prior to skin involvement, 17 (34%) had skin metastases first and 2 (4%) had simultaneous presentation. Clinical outcome was: 29 (45%) dead of disease; 24 (37%) alive with disease; 12 lost to follow up. Mean time to death was: (1) 80 (9-224) months from primary diagnosis; 45 (5-94) from first metastasis to any site; 27 (5-65) months from first skin metastasis.

Diagnosis of Primary Sarcomas Resulting in Skin Metastasis
Leiomyosarcoman=28
Epithelioid Sarcoman= 5
Angiosarcoman= 5
Undifferentiated Pleomorphic Sarcoman= 4
Osteosarcoman= 4
Alveolar Soft Part Sarcoman= 3
GISTn= 2
Synovial Sarcoman= 2
Unclassified sarcoman= 2
Various (10 types, 1 each)n=10



Conclusions: Sarcoma metastases to the skin are rare. In this large study, leiomyosarcoma was the most common source and scalp the most frequent site. The majority of patient with skin metastases has harbored previous metastases elsewhere. However, skin metastasis was the initial site in about 1/3 of cases. Thus, clinical correlation is needed before establishing a diagnosis of primary cutaneous sarcoma, particularly leiomyosarcoma of scalp. Finally, skin metastasis is usually a late event in sarcoma clinical progression and heralds a poor prognosis.
Category: Bone & Soft Tissue

Monday, March 22, 2010 1:00 PM

Poster Session II # 20, Monday Afternoon

 

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