P1794 - Mesenchymal Chondrosarcoma With Metastasis to the Pancreas

Nirav Agrawal, MD, MPH¹, Scarlet Louis-Jean, MD, MBA, MSAN², Rahul Mishra, MD³, Sara Negash, MD⁴, Steven Fleisher, MD⁵, Sanmeet Singh, MD^2
1Luminis Health/ Anne Arundel Medical Center, Pasadena, MD; ²Luminis Health, Annapolis, MD; ³Anne Arundel Medical Center, Annapolis, MD; ⁴Luminish Health, Annapolis, MD; ⁵Luminis Health Anne Arundel Medical Center, Annapolis, MD

Introduction: Mesenchymal chondrosarcoma is a biomorphic aggressive neoplasm that is often localized to the skeletal system, with rare extra-skeletal metastasis. The tumor rarely involves somatic soft tissue like the pancreas. Diagnosis is often made with fine needle aspiration, with treatment involving surgical resection with the addition of a controversial chemotherapy cocktail and/or radiotherapy.

Case Description/Methods: A 33-year-old Hispanic male with a history of mesenchymal chondrosarcoma of the right thorax status post chemotherapy and radiation with right thoracotomy en-bloc resection of the chest wall and tumor presented with jaundice and intermittent epigastric pain. Imaging studies revealed multiple lung nodules, obstructed common bile duct, and pancreatic mass. Endoscopic ultrasound-guided fine needle aspiration confirmed metastatic chondrosarcoma to the pancreas. After endoscopic biliary stent placement, his acute symptoms resolved. However, due to the extensive malignancy, surgery was not recommended. The patient was discharged home with hospice care after a multidisciplinary discussion regarding the prognosis and goals of care.

Discussion: Mesenchymal chondrosarcoma (MCS) is a rare and aggressive subtype of chondrosarcoma with a high risk of metastasis. It often presents as a small round blue cell tumor and can mimic other malignancies, making diagnosis challenging. Treatment typically involves multimodal therapy, including surgery, chemotherapy, and radiation, but the prognosis remains poor, especially in metastatic disease. Unfortunately, our patient was not a candidate for further medical or surgery management due to the extension of the malignancy. The patient was discharged home on hospice care.



Disclosures:


Nirav Agrawal, MD, MPH¹, Scarlet Louis-Jean, MD, MBA, MSAN², Rahul Mishra, MD³, Sara Negash, MD⁴, Steven Fleisher, MD⁵, Sanmeet Singh, MD². P1794 - Mesenchymal Chondrosarcoma With Metastasis to the Pancreas, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.