Chondrosarcoma of the Jaw: A Closer Look at its Management (original) (raw)

Case report: Chondrosarcoma of the head and neck

Human Pathology: Case Reports, 2017

Chondrosarcoma originates in the bones of the head and neck. It is an unusual neoplasm that is slow-growing and represents only 1-3% of all cases of chondrosarcoma. Here, we report a case of a 45year-old male Caucasian patient treated at Hospital Amaral Carvalho with a history of swelling of the face and a tumoral mass in the right maxilla with infiltration into the skin, which had been present for 4 months. A computerized tomography (CT) of the face and sinuses demonstrated a lesion in the right maxilla. A maxilectomia without orbital exenteration was performed. It was diagnosed as a grade III chondrosarcoma, with infiltration into the subjacent bone, anterior wall of the maxillary sinus and floor of the orbit. The patient presented with recurrence of the tumor after adjuvant therapies. A molecular study on the present case showed an unusually large number of abnormalities. This finding demonstrated extreme chromosomal instability, which was likely due to the undifferentiation of the tumor. Although there are no cases in the literature with which to compare, these findings may elucidate potential therapeutic targets for advanced tumors without other therapeutic options.

Mesenchymal Mandibular Chondrosarcoma: A Case Report and Review of Literature

Open Journal of Stomatology

Introduction: Chondrosarcomas (CS) are malignant cartilaginous tumors of rare maxillary localization. Their evolution is generally slow in time. They have a high tendency for locoregional recurrence after surgical treatment. Their prognosis depends on their degree of differentiation and the quality of resection. The authors report a clinical case of mesenchymal mandibular chondrosarcoma (MC), which is considered to be a subtype of CS, and specify the epidemiological, diagnostic, therapeutic and evolutionary features of this tumor. Case Report: A 73-year-old woman reported in February 2018 in our department complained of a slowly enlarging mass involving the right part of the lower jaw for the last 18 months. On examination a firm multilobular painful mass was palpated with cortical expansion, occupying the right side. A CT scan with 3D reconstruction was achieved and showed osteolysis lesions and cortical thickening. The mass biopsy for histological examination found a grade I well-differentiated bone chondrosarcoma. We performed a hemi-mandibulectomy with complete resection of the tumor. The anatomopathologic examination of the resection specimen was in favour of a grade II mesenchymal chondrosarcoma. No radiotherapy was needed. The patient's follow up was uneventful. Discussion: CS grading is the key to its management. Low grade CS (grades I and II) of the facial skeleton are luckily the most common, they are best treated with a local resection using 1.5 cm margins for bone and soft tissue. According to published literature, CS was historically considered as a radio resistant tumor. Radiotherapy and chemotherapy were therefore mainly reserved for high-grade tumors and for non-operable lesions. However, radical local surgery appears to be the treatment of choice for low grade chondrosarcoma. Conclusion: CS's definitive diagnosis depends on appropriate radiographic evaluation along with adequate biopsy with meticulous histopathological examination and adjunctive immunohistochimical analysis. Neither chemotherapy nor radiotherapy is indicated as primary treatment. A long period follow-up should be advised as recurrence How to cite this paper: Abouchadi, A.,

Chondrosarcoma of body of the mandible

National Journal of Maxillofacial Surgery, 2013

Chondrosarcomas are the malignant cartilaginous neoplasms rarely seen in the head and neck region. The chondrosarcomas may show an aggressive course and are mostly located in relation with anterior maxilla and base of the skull. Chondrosarcomas of the body of mandible are infrequent. We report a case of low-grade chondrosarcoma of body of mandible, which was treated with a simple excision without neck dissection.

Clinicopathologic correlation of chondrosarcoma of mandible with a case report

Contemporary Clinical Dentistry, 2011

Chondrosarcoma is a rare primary malignant neoplasm of the head, neck, oral and maxillofacial regions. The clinicopathological and radiographic findings are usually characteristic; however, not decisive. The neoplasm is usually treated by wide surgical resection because it is traditionally radioresistant. However, radiotherapy is generally advised for high-grade lesions, and chemotherapy has a palliative role. The treatment and management are primarily guided by the histological grades of the neoplasm. Prognosis of jaw lesions is poor as compared to the lesions affecting the long bones of the body, and the cause of death is usually by direct extension in the base of the skull or due to distant metastasis to lungs and other bones. A clinical case of chondrosarcoma, involving the right half of mandible of a 36 year old male patient is discussed herewith, encompassing the entire gamut of clinicopathological, radiological and treatment modalities rendered.

Surgical management of chondrosarcomas of Head and Neck

Chondrosarcomas are uncommon malignant mesenchymal neoplasms that are rare in the head and neck region. They affect mainly the maxilla, while relatively few arise from the mandible, nasal cavity, larynx, skull and cervical vertebrae. Radical surgical resection with a wide margin of normal tissue is the treatment of choice, while radiotherapy and chemotherapy are reserved as adjunctive therapies for tumours where enbloc resection is not feasible.

Mandibular periosteal (juxtacortical) chondrosarcoma

Brazilian Dental Journal, 2009

Periosteal (juxtacortical) chondrosarcoma (PC) is a well-differentiated malignant cartilage-forming tumor arising from the external bone surface, especially in long bones. The therapy of choice is en-bloc resection and, in general, its prognosis is good. This paper reports a rare case of PC affecting the mandible of a 41-year-old man. The lesion presented as a slow-growing-painless swelling that lasted 2 months. Computed tomography scan showed a tumoral mass arising from the external bone surface, extending into the adjacent soft tissue presenting patchy regions of popcorn-like calcifications. A final diagnosis of PC (grade II) was rendered after biopsy. Hemimandibulectomy was undertaken followed by complementary radiotherapy with 70 Gy. Although no episodes of recurrence or metastasis had been noticed after 18 months of follow-up, the patient died and causa mortis could not be established.

Laryngeal Chondrosarcoma: An Exceptional Localisation of a Not Unfrequent Bone

2013

After osteosarcoma, chondrosarcoma is the second most common primary bone tumor accounting for 26 % of all malignancies. In the laryngeal region however, chondrosarcomas are rather rare. Only 300 cases are reported in literature. Considering laryngeal chondrosarcoma, about 75 % occur in the cricoid cartilage, whereas 20 % occur in the thyroid cartilage. In this paper we report a case of thyroidal chondrosarcoma, and based on a thorough literature search we suggest some practical guidelines concerning diagnosis and therapy. Copyright © 2009 Mieke Moerman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 1.

Clinicopathological and histological behavior of mesenchymal chondrosarcoma involving maxilla

Journal of Oral and Maxillofacial Pathology, 2017

Chondrosarcoma (CS) is an uncommon, slow enlarging malignant neoplasm that originates from primitive cartilage forming mesenchyme, and produces a pure hyaline cartilage that results in abnormal bone and/or cartilage growth. [1] It is the second most common primary bone cancer after osteosarcoma. [2] The involvement of the craniofacial region is very rare and accounts for <10% of all CSs. [2] Different types of CS have been described as follows: [3] • Conventional CS-which accounts for nearly 90% of all CSs • Dedifferentiated CS • Clear cell CS • Mesenchymal chondrosarcoma (MC) • Juxtacortical CS • Secondary CS. MCs are relatively rare malignancies of bone and soft tissue with cartilaginous differentiation. [4] Fewer than 2% of all CSs are MCs. The maxilla and mandible are the most common sites of involvement, followed by the vertebrae, the ribs, the pelvis and the humerus. [3] It was first described by Lightenstein and Bernstein in 1959 as a biphasic tumor, comprising spindle cells interspersed with areas of chondroid differentiation. [5] Usually, MCs of the head and neck region arise from the maxilla, with relatively few arising from the mandible. [6] Females are more frequently affected than males. It is commonly seen in younger age group compared with conventional CS. [7] The majority of MCs are asymptomatic, although some patients present with rapidly invasive asymptomatic swellings, resulting in loosening of the teeth and expansion of the cortical plates. [8] Radiographically, it is difficult to differentiate between MC from other cartilaginous neoplasms or Mesenchymal chondrosarcoma (MC) is a rare variety of chondrosarcoma (CS), which is both clinically unique and histologically distinct compared with conventional CS. Maxillofacial MCs are aggressive, have a tendency for recurrence and significant distant metastasis to lung and bone, and are associated with overall poor prognosis. Histopathologically, it is a biphasic tumor comprising of islands of hyaline cartilage with undifferentiated small round cells. Here, we present an interesting case of MC involving the left half of maxilla along with a brief review of the relevant literature.