Clinicopathologic correlation of chondrosarcoma of mandible with a case report

Abstract

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.

Keywords: Chondrosarcoma; egg-shell crackling; ground-glass; metastasis; mitotic figures; segmental mandibulectomy; sun-burst.

Figure 1

Extra-oral photograph showing the presence of a medium sized diffused swelling involving the right side of mandible, and covered with normal appearing skin of the patient in the case report

Figure 2

Intra-oral photograph showing the presence of a lobulated central swelling in right mandibular —premolar molar region causing the expansion of both the cortical plates and covered by intact overlying mucosa of the patient in the case report

Figure 3

Orthopantomogram (dental panoramic radiograph) showing an irregular radiolucent lesion interspersed with radioopacity with concomitant marked alveolar bone destruction, resorption of the mesial root of first molar tooth and thinning of the lower border of the mandible of the patient in the case report

Figure 4

Coronal computed tomography scan revealing the presence of a large osteolytic lesion involving the right body of mandible showing sun-ray appearance and expansion of the cortical plates of the patient in the case report

Figure 5

Low power photomicrograph showing proliferated mass of cartilaginous tissue with marked cellular and nuclear pleomorphism of the patient in the case report (H&E, ×10)

Figure 6

High power photomicrograph showing pronounced features of cellular and nuclear pleomorphism of the patient in the case report (H&E, ×40)

Figure 7

Surgically resected portion of the right half of mandible of the patient in the case report

Figure 8

Post-operative extra-oral clinical status of the patient in the case report