1 research outputs found
Role of skeletal scintigraphy in soft tissue sarcoma: Improving the diagnostic yield
Background: The presence of skeletal metastases significantly
influences the therapeutic strategy adopted for soft tissue sarcoma.
However, literature on the prevalence of skeletal metastases in soft
tissue sarcoma is limited and none of the available data is based on
the Indian patient population. Aim: To determine the prevalence of
skeletal metastases at presentation in patients of soft tissue sarcoma
and to rationalise the use of preoperative skeletal scintigraphy in
such patients. Methods and Material: Preoperative bone scans were
evaluated in 122 patients with soft tissue sarcoma (median age, 34
years; range, 4-83). The scans were classified into 3 grades: Grade 1:
metastases very likely; Grade 2: equivocal; Grade 3: normal or benign
lesion. In all the patients studied, the ability of the patient to
localize the site or sites of pain was recorded and that was correlated
with the site of metastases in scintigraphy. Result: Seventeen
(13.9%) patients had Grade 1 scan; 16 of them had bony pain that was
not readily explainable by trauma or other local factors. Ten ( 8.1%)
patients had Grade 2 scan, five of them had bony pain which was not
readily explainable by trauma or other local factors. Ninety-five
patients (77.8%) had Grade 3 scan. Of these, 9 had localised bone pain
which could be definitely associated with trauma or joint degeneration.
Conclusion: The prevalence of skeletal metastases at presentation in
patients with soft tissue sarcoma is low (13.9%). The low rates of
skeletal metastases in bone pain-free patients (0.9%) versus the high
rate in symptomatic patients (76.1%) supports the use of bone scanning
in symptomatic patients only