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Chemotherapy Improved Prognosis of Mesenchymal Chondrosarcoma with Rare Metastasis to the Pancreas

DOI: 10.1155/2014/249757

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Abstract:

Extraskeletal mesenchymal chondrosarcoma is rare and metastasis to the pancreas is extremely rare, with only four cases reported in the literature. The therapeutic effectiveness of chemotherapy remains uncertain. We report a 39-year-old man with extraskeletal mesenchymal chondrosarcoma of the buttock, who had metastases to the pancreas, bones, and lung. He underwent distal pancreatectomy, resection of the buttock tumor, and chemotherapy. He had a good response to chemotherapy and survived for about 3 years after surgery. 1. Introduction Mesenchymal chondrosarcoma is a rare malignant neoplasm characterized by a biomorphic pattern of poorly differentiated small round cells and islands of well-differentiated hyaline cartilage. This tumor has a widespread distribution. The craniofacial bones (especially the jaw bones), ribs, ilium, and vertebrae are the most common sites. One-fifth to one-third of the lesions are extraskeletal, primarily affecting the somatic soft tissues [1]. Metastasis to the pancreas is extremely rare, with only four cases reported in the literature [2–6]. We herein report a 39-year-old man with extraskeletal mesenchymal chondrosarcoma of the buttock, with metastasis to the pancreas. 2. A Case Report A 39-year-old man presented with a 4-month history of severe upper abdominal pain after drinking alcohol. The patient denied any significant past medical or surgical history. Physical examination did not reveal any abdominal mass, and laboratory data including tumor markers (CEA, CA19-9, and DUPAN-2) showed no abnormalities. Abdominal computed tomography (CT) showed a well-circumscribed, low-attenuation, inhomogeneously enhancing mass measuring about 5?cm in diameter in the body and tail of the pancreas. There were no signs of invasion of the surrounding tissues or dilatation of the distal pancreatic ducts. The CT findings were not typical for pancreatic cancer (Figure 1(a)). CT also showed a well-circumscribed, heterogeneously enhancing mass measuring about 8?cm × 3?cm in the left buttock (Figure 1(b)). Magnetic resonance imaging of the abdomen showed a well-circumscribed mass measuring 4.5?cm in diameter in the body and tail of the pancreas. The mass was hypointense with punctate hyperintense areas on T1-weighted images and slightly hyperintense on T2-weighted images and showed inhomogeneous enhancement with gadolinium diethylenetriaminepentaacetic acid on T1-weighted fat-suppression images (Figure 1(c)). The radiological differential diagnosis included neoplasm of the endocrine pancreas and solid pseudopapillary tumor. Magnetic resonance

References

[1]  Y. Nakashima, G. de Pinieux, and M. Ladanyi, “Mesenchymal chondrosarcoma,” in WHO Classification of Tumours of Soft Tissue and Bone, pp. 271–272, IARC, Lyon, France, 2013.
[2]  Z. Kasper, F. Carlos, W. David, S. Honorio, and L. Andrew, “Metastases to the pancreas and their surgical extirpation,” Archives of Surgery, vol. 133, no. 4, pp. 413–417, 1998.
[3]  T. Komatsu, S. Taira, O. Matsui, T. Takashima, M. Note, and H. Fujita, “A case of ruptured mesenchymal chondrosarcoma of the pancreas,” Radiation Medicine, vol. 17, no. 3, pp. 239–241, 1999.
[4]  H. Yamamoto, K. Watanabe, M. Nagata et al., “Surgical treatment for pancreatic metastasis from soft-tissue sarcoma,” The American Journal of Clinical Oncology, vol. 24, no. 2, pp. 198–200, 2001.
[5]  P. Chatzipantelis, E. Karvouni, G. P. Fragoulidis, D. Voros, and A. Pafiti, “Clinicopathologic features of two rare cases of mesenchymal metastatic tumors in the pancreas: review of the literature,” Pancreas, vol. 33, no. 3, pp. 301–303, 2006.
[6]  L. Lichtenstein and D. Bernstein, “Unusual benign and malignant chondroid tumors of bone,” Cancer, vol. 12, pp. 1142–1157, 1959.
[7]  E. A. Dowling, “Mesenchymal chondrosarcoma,” The Journal of Bone and Joint Surgery (American Volume), vol. 46, pp. 747–754, 1964.
[8]  L. G. Shapeero, D. Vanel, D. Couanet, G. Contesso, and L. V. Ackerman, “Extraskeletal mesenchymal chondrosarcoma,” Radiology, vol. 186, no. 3, pp. 819–826, 1993.
[9]  Y. Nakashima, K. K. Unni, T. C. Shives, R. G. Swee, and D. C. Dehlin, “Mesenchymal chondrosarcoma of bone and soft tissue. A review of 111 cases,” Cancer, vol. 57, no. 12, pp. 2444–2453, 1986.
[10]  A. G. Huvos, G. Rosen, M. Dabska, and R. C. Marcove, “Mesenchymal chondrosarcoma. A clinicopathologic analysis of 35 patients with emphasis on treatment,” Cancer, vol. 51, no. 7, pp. 1230–1237, 1983.
[11]  M. A. Nooij, J. Whelan, V. H. Bramwell et al., “Doxorubicin and cisplatin chemotherapy in high-grade spindle cell sarcomas of the bone, other than osteosarcoma or malignant fibrous histiocytoma: a European Osteosarcoma Intergroup Study,” European Journal of Cancer, vol. 41, no. 2, pp. 225–230, 2005.
[12]  M. Cesari, F. Bertoni, P. Bacchini, M. Mercuri, E. Palmerini, and S. Ferrari, “Mesenchymal chondrosarcoma. An analysis of patients treated at a single institution,” Tumori, vol. 93, no. 5, pp. 423–427, 2007.
[13]  A. R. Harwood, J. I. Krajbich, and V. L. Fornasier, “Mesenchymal chondrosarcoma: a report of 17 cases,” Clinical Orthopaedics and Related Research, vol. 158, pp. 144–148, 1981.
[14]  D. Sevel, “Mesenchymal chondrosarcoma of the orbit,” The British Journal of Ophthalmology, vol. 58, no. 10, pp. 882–887, 1974.
[15]  H. Gelderblom, P. C. Hogendoorn, S. D. Dijkstra et al., “The clinical approach towards chondrosarcoma,” Oncologist, vol. 13, no. 3, pp. 320–329, 2008.

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