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病例报告:骨外间叶性软骨肉瘤伴罕见的胰腺转移。

Case report: Extraskeletal mesenchymal chondrosarcoma with a rare metastasis to the pancreas.

作者信息

Zhu Xiuliang, Cheng Lu, Dong Fei, Cai Jinsong, Qian Wei, Ding Qiao-Ling

机构信息

Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Department of Pathology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Front Oncol. 2024 Oct 9;14:1324732. doi: 10.3389/fonc.2024.1324732. eCollection 2024.

Abstract

BACKGROUND

Extraskeletal mesenchymal chondrosarcoma (ESMC), an uncommon and highly aggressive form of chondrosarcoma, is characterized by its mesenchymal origin and absence of skeletal involvement. Only a few cases of primary ESMC with metastasis to the pancreas have been reported so far. In this study, we present a case of ESMC in the left thigh with a solitary pancreatic metastasis in a 45-year-old woman. Additionally, we provide a thorough overview of ESMC, encompassing its entire clinical progression and radiographic observations. Furthermore, we reviewed all thirteen cases of pancreatic metastasis, including this present case, analyzing patient attributes, clinical management, and prognosis.

CASE PRESENTATION

A 45-year-old woman has had a painless mass in her left thigh for one year. X-ray, computed tomography (CT), and magnetic resonance imaging of the left thigh were performed. Positron emission tomography-CT imaging showed a high accumulation in the left thigh tumor and the pancreatic neck lesion. A diagnosis of extraskeletal chondrosarcoma with pancreatic metastasis was determined based on the radiological examinations. A final diagnosis of ESMC was confirmed by histopathological and immunohistochemical examinations after surgical resection. The patient presented metastasis in the lung, right groin, and tail of the pancreas successively, and mostly received complete surgical excision during a 39-month follow-up with postoperative chemotherapy.

CONCLUSION

We present a highly uncommon case of ESMC spreading to the pancreas and highlight the importance of recognizing the distinctive imaging features of ESMC for diagnosis and prognosis assessment.

摘要

背景

骨外间叶性软骨肉瘤(ESMC)是一种罕见且侵袭性很强的软骨肉瘤,其特征是起源于间叶组织且不累及骨骼。迄今为止,仅有少数原发性ESMC转移至胰腺的病例报道。在本研究中,我们报告了一例45岁女性左大腿ESMC伴孤立性胰腺转移的病例。此外,我们全面概述了ESMC,包括其整个临床病程及影像学表现。此外,我们回顾了包括本病例在内的所有13例胰腺转移病例,分析了患者特征、临床处理及预后情况。

病例介绍

一名45岁女性左大腿出现无痛性肿块1年。对左大腿进行了X线、计算机断层扫描(CT)及磁共振成像检查。正电子发射断层扫描-CT成像显示左大腿肿瘤及胰腺颈部病变有高摄取。根据影像学检查诊断为骨外软骨肉瘤伴胰腺转移。手术切除后经组织病理学和免疫组化检查确诊为ESMC。患者先后出现肺、右腹股沟及胰尾转移,在39个月的随访期间大多接受了完整手术切除及术后化疗。

结论

我们报告了一例极为罕见的ESMC转移至胰腺的病例,并强调了认识ESMC独特影像学特征对诊断及预后评估的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d1a/11496084/0ada0c71a6b2/fonc-14-1324732-g001.jpg

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