Which one of the following soft tissue sarcomas frequently metastasizes to lymph nodes? (AIPG 2010)
|D||Alveolar soft part sarcoma|
"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
• Clear cell sarcoma
• Epithelial sarcoma
• Fibrosarcoma (rarely)
• Malignant fibrous histiocytoma
• Synovial cell sarcoma
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.