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Pathology

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Miscellaneous

Question
19 out of 28
 

Which one of the following soft tissue sarcomas frequently metastasizes to lymph nodes? (AIPG 2010)



A Fibrosarcoma

B Osteosarcoma

C Embryonal rhabdomyosarcoma

D Alveolar soft part sarcoma

Ans. C i.e. Embryonal rhabdomyosarcoma

"Lymph node metastasis is rare except in synovial and epithelioid sarcoma, clear cell sarcoma, angiosarcoma and rhabdomyosarcoma."

a. Spread of soft tissue sarcoma:

i. Mostly hematogenous: MC site lung parenchyma

ii. Retroperitoneal sarcoma and GIST metastasize hematogenously most commonly to liver.

iii. Lymphatic spread as seen in :

Mnemonic = RACE For MS

Rhabdomyosarcoma

Angiosarcoma

Clear cell sarcoma

Epithelial sarcoma

Fibrosarcoma (rarely)

Malignant fibrous histiocytoma

Synovial cell sarcoma

b. Remember:

i. Soft tissue sarcoma tends to grow along plane (Le. tissue plane) and compress the surrounding tissue to form pseudocapsule.

ii. Highest Incidence of lymphatic metastasis is in embryonal rhabdomyosarcoma.

iii. Presence of nodal metastasis is designated as stage IV disease.

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