Aortic Sarcoma Patients With Bone Metastasis.

ABSTRACT

BACKGROUND: Metastases to the bone of aortic sarcoma include osteolytic and non-osteolytic lesions. This study aims to review the clinical symptoms, the sites and diagnostic methods of bone metastases and to compare the osteolytic and non-osteolytic metastases of patients with aortic sarcoma. METHODS: A systematic search was conducted in PubMed and scientific journals published from 1972 to 2022. Database included reports of aortic sarcomas with bone metastasis published in english and in french. Characteristics of patients were analyzed with Chi-square test or Fisher's exact test between lytic and sclerotic bone metastases. RESULTS: In 29 patients with bone destruction, the symptoms of low back pain and claudication were observed in 10 (34.5%), and 9 cases (31%), respectively. Acute ischemia of the legs and arms accounted for 7 cases (24.1%). There were 4 cases with hypertension (13.8%) and 5 cases with chest pain or abdominal pain or epigastric pain (17.2%). Metastases to the vertebrae, pelvis, femur were observed in 14 (48.3%), 12 (41.4%) and 11 cases (37.9%), respectively. Osteolytic lesions were detected at the time of diagnosis in 16/29 (55.2%) cases. In 27 aortic sarcoma patients with sclerotic bone metastases, symptoms of hypertension were observed in 10 (37.0%), of back pain in 7 (25.9 %), of chest pain or abdominal pain in 5 cases (18.5%). Acute ischemia of the leg occurred in 6 cases (22.2%). Metastases to the vertebrae, bone, pelvis, and femur were observed in 10 (37.0%), 9 (33.3%), 7 (25.9%), and 6 cases (22.2%), respectively. The sign of claudication and methods for detected bone destruction by X-rays were the difference between osteolytic and non-osteolytic metastases of aortic sarcoma (p=0,019; p=0,001), respectively. CONCLUSIONS: Back pain is a common symptom of aortic sarcoma with bone metastasis. The sign of intermittent claudication is the difference between osteolytic and non-osteolytic metastases of aortic sarcoma. Bone destruction occurred in all bones, but mainly in vertebrae, pelvis, femur. Methods for detection of bone destruction mainly by X-rays or CT. Bone destruction was an important sign to detect aortic sarcoma. Sclerotic bone metastases occurred mainly in vertebrae, pelvis, bone and femur. The detection of sclerotic bone metastases based on MRI, PET/CT and autopsy.