2007 Volume 22 Issue 4 Pages 494-502
A 36-year-old male who had received an operation for malignant meningioma in 2001 was admitted to a hospital for acute pancreatitis. An abdominal CT scan demonstrated a mass including a calcification at the pancreas body. This calcification was judged to be a benign change due to the chronic pancreatitis. He was admitted to our hospital six months later because the follow up abdominal CT scan demonstrated enlargement of the mass. The pancreatic mass was 5cm in size, and contained calcification. Tumor thrombosis of the portal vein was seen extensively. An operative biopsy was performed because radical operation was considered to be difficult. The tumor consisted of proliferated mesenchymal tumor cells, which were positive for c-kit immunohistochemically. Therefore, the pancreatic tumor was diagnosed as GIST of the pancreas. Despite treatment with STI-571, the tumor enlarged remarkably and the patient died of a rupture of the tumor. By autopsy, the pancreatic tumor was diagnosed as mesenchymal chondrosarcoma. In the review of past specimens, it was concluded that the pancreatic tumor had metastasised from the mesenchymal chondrosarcoma of the dura mater which had been diagnosed as malignant meningioma and removed at the first operation for the brain tumor in 2003. Pancreatic metastases of mesenchymal chondrosarcoma are rare, and only five cases have been reported. Furthermore, to our knowledge, this case of mesenchymal chondrosarcoma was the first to be described that was positive for c-kit.
