Brain Metastases in Soft Tissue Sarcomas: Case Report and Literature Review

[摘要] Background and purpose:Brain metastasis is a relatively uncommon event in the natural history of soft tissue sarcomas.The increasing use of chemotherapy may have caused a reduction in local relapses as well as distant failures leading to animprovement in survival, thereby allowing metachronous seeding of the brain, a sanctuary site. The purpose of this report isto increase awareness amongst clinicians regarding such a possibility.Patients and methods:A review of the departmental sarcoma database following the presentation of this index case in theclinic.Results and discussion:An adolescent male who had previously been treated with surgery and radiotherapy for a spindle cellsarcoma of the left thigh developed a space-occupying lesion in the brain within 6 months of treatment of the primarytumor. He subsequently underwent resection of the presumed solitary brain metastasis followed by whole brainradiotherapy. On radiation he was detected to have pulmonary metastases too, for which he was offered palliativechemotherapy. The patient died of brain metastasis within 4 months. A review of the departmental sarcoma database,restricted to soft tissue sarcomas purely, maintained prospectively from 2000 till date, could not identify any other suchcase.Conclusion:Brain metastases from soft tissue sarcomas are rare. Patients with neurological symptoms, however, shouldbe appropriately investigated. Surgical resection of brain metastasis could be considered for solitary brain metastasisin non-eloquent areas. Palliative radiotherapy is appropriate for patients with multiple brain metastases or co-existingextra-cranial disease.

[学科分类] 肿瘤学