Extraskeletal Mesenchymal Chondrosarcoma, a Rare Entity with Unusual Metastases: A Case Report
Introduction: Extraskeletal Mesenchymal Chondrosarcoma (ESMC) are rare, aggressive, high grade malignant tumors originating from soft tissues. It carries poor prognosis with tendency for local recurrence and distant metastasis; necessitating long term follow up. Most common site for metastasis is lungs. Other sites are bones and lymph nodes. Pancreatic metastases are extremely rare. Case description: 35-year-old female presented with history of wide local excision for left upper limb mass; histopathology showed ESMC. She was on surveillance with Computed Tomography (CT) scan of thorax and Magnetic Resonance Imaging (MRI) of left upper limb at 3-months interval until she developed vertebral and pancreatic lesions after interval of 6 months since surgery. No pulmonary metastases were noted. Considering the unusual site for metastasis and to exclude possibility of any second malignancy, bone biopsy and endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) were performed that confirmed metastases. Later she developed osseous metastases in pelvis and femora. Practical implication: Pancreatic metastasis from ESMC are extremely rare. In case of new visceral or osseous lesions in a patient with past history of ESMC, possibility of metastatic disease should be taken into consideration. Biopsy can be performed to confirm the diagnosis.
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