J Korean Assoc Oral Maxillofac Surg.  2010 Apr;36(2):128-133. 10.5125/jkaoms.2010.36.2.128.

Mesenchymal chondrosarcoma on right mandible: a case report

• Suh JH
• Kim YG
• Kwon YD
• Choi BJ
• Kim YR
• Lee BS

• KMID: 2189992
• DOI: http://doi.org/10.5125/jkaoms.2010.36.2.128

Abstract

Mesenchymal chondrosarcoma is very aggressive and represents approximately 1% of all chondrosarcomas. While it affects a very wide age range, the peak frequency is in the second decade of life. It may occur in the head and rib region with a predilection for the maxillofacial skeleton. The small cell undifferentiated component may assume a hemangiopericytoma-like vascular pattern and should be distinguished from hemangiopericytoma. Treatment is en bloc resection, the intended tissue margins of excision should be designed to extend well beyond the actual tumor margin, as mesenchymal chondrosarcomas. Aggressive behavior of mesenchymal chondrosarcoma of the jaw, with a tendency for delayed recurrence and metastasis even many years after treatment. The most frequent site of metastasis was the lung. Here we present 52 years old , female case of mesenchymal chondrosarcoma occurs on Rt. mandible.

Keyword

Mesenchymal chondrosarcoma; Hemangiopericytoma; Chondrosarcoma

MeSH Terms

Chondrosarcoma
Chondrosarcoma, Mesenchymal
Female
Head
Hemangiopericytoma
Humans
Jaw
Lung
Mandible
Neoplasm Metastasis
Recurrence
Ribs
Skeleton

Figure

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  Fig. 1. Gingival swelling and indulation observed on right posterior mandibular area.

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  Fig. 2. Panoramic view of 57-years-old showing radiolucent lesion on right mandible and root resorption on involved teeth. Irregular and poor defined margin are observed.

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  Fig. 3. Section from mandible shows undifferentiated small round cell proliferation with hemangiopericytomatous vascular pattern. Although definite hyaline cartilage island is not seen.(H&E, x100)

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  Fig. 4. Preoperative CT. CT shows mass at right mandible body invasion to left sublingual space, mylohyoid muscle and right mandibular buccal space. (CT: computed tomography)

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  Fig. 5. A slightly imbalanced intake of FDG was found on the right posterior mandibular area. (FDG: fluorodeoxyglucose)

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  Fig. 6. Preoperative MRI. Highly suggesting malignant mass at right mandible body invasion to right buccal space, right sublingual space, mylohyoid muscle. (T1 weighted image)(MRI: magnetic resonance imaging)

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  Fig. 7. Postoperative panorama. Reconstruction using by bridging plate & radial forearm flap.

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  Fig. 8. Mass appears relatively well defined margin and measured about 70×45×35 mm.

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  Fig. 9. Section shows mass consisted of undifferentiated small round cell proliferation with hemangiopericytomatous vascular pattern and amorphous chondroid tissue. (H&E, x100)

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  Fig. 10. Panorama shows fracture occurred on reconstructive bridging plate.

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  Fig. 11. More heavy plate using on secondary surgery.

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  Fig. 12. Fracture occurred the second time.

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  Fig. 13. Reconstruction using by block bone on iliac crest and reconstruction bridging plate.

Reference

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