CNS Metastases from Bone and Soft Tissue Sarcomas in Children, Adolescents, and Young Adults: Are They Really So Rare?

Abstract EN

Purpose.

To check whether primary involvement of brain/spinal cord by bone/soft tissue sarcomas’ metastases in children is as rare as described and to present various morphological forms of bone/soft tissue sarcomas’ CNS metastases.

Methods.

Patients with first diagnosis in 1999–2014 treated at single center were included with whole course of disease evaluation.

Brain/spinal canal magnetic resonance imaging (MRI)/computed tomography were performed in cases suspicious for CNS metastases.

Extension from skull/vertebral column metastases was excluded.

Results.

550 patients were included.

MRI revealed CNS metastases in 19 patients (incidence 3.45%), 14 boys, aged 5–22 years.

There were 12/250 osteosarcoma cases, 2/200 Ewing’s sarcoma, 1/50 chondrosarcoma, 3/49 rhabdomyosarcoma (RMS), and 1/1 malignant mesenchymoma.

There were 10 single metastases and 7 cases of multiple ones; in 2 RMS cases only leptomeningeal spread in brain and spinal cord was found.

Calcified metastases were found in 3 patients and hemorrhagic in 4.

In one RMS patient there were numerous solid, cystic, hemorrhagic lesions and leptomeningeal spread.

Conclusions.

CNS metastases are rare and late in children with bone/soft tissue sarcomas, although in our material more frequent (3.45%) than in other reports (0.7%).

Hematogenous spread to brain and hemorrhagic and calcified lesions dominated in osteosarcoma.

Ewing sarcoma tended to metastasize to skull bones.

Soft tissue sarcomas presented various morphological forms.