Journal List > J Korean Assoc Oral Maxillofac Surg > v.36(2) > 1032377

Suh, Kim, Choi, Kim, Lee, and Kwon: Mesenchymal chondrosarcoma on right mandible: a case report

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.

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Fig. 1.
Gingival swelling and indulation observed on right posterior mandibular area.
jkaoms-36-128f1.tif
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.
jkaoms-36-128f2.tif
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)
jkaoms-36-128f3.tif
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)
jkaoms-36-128f4.tif
Fig. 5.
A slightly imbalanced intake of FDG was found on the right posterior mandibular area. (FDG: fluorodeoxyglucose)
jkaoms-36-128f5.tif
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)
jkaoms-36-128f6.tif
Fig. 7.
Postoperative panorama. Reconstruction using by bridging plate & radial forearm flap.
jkaoms-36-128f7.tif
Fig. 8.
Mass appears relatively well defined margin and measured about 70×45×35 mm.
jkaoms-36-128f8.tif
Fig. 9.
Section shows mass consisted of undifferentiated small round cell proliferation with hemangiopericytomatous vascular pattern and amorphous chondroid tissue. (H&E, x100)
jkaoms-36-128f9.tif
Fig. 10.
Panorama shows fracture occurred on reconstructive bridging plate.
jkaoms-36-128f10.tif
Fig. 11.
More heavy plate using on secondary surgery.
jkaoms-36-128f11.tif
Fig. 12.
Fracture occurred the second time.
jkaoms-36-128f12.tif
Fig. 13.
Reconstruction using by block bone on iliac crest and reconstruction bridging plate.
jkaoms-36-128f13.tif
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