Myxoid chondrosarcoma of the mandible in a 22-year-old man: A case report

Abstract

This study describes a case of myxoid chondrosarcoma of the mandible in a 22-year-old male patient. A tumour in the buccal gingiva of the lower left premolar region had been identified 2 years earlier. Whole-jaw panoramic radiographs showed a hypodense shadow in the mesiodistal area near the roots of teeth 34 and 35. A maxillofacial computed tomography scan revealed a mass in the lower left premolar soft tissue, with a shadow indicating bone destruction, a clear boundary and uniform density. The preliminary diagnosis at the outpatient department was 34-35 epulis. The patient underwent surgery for 34-35 gingival tumour resection, 34 and 35 extraction, and 34 and 35 immediate implantation. The postoperative pathological examination revealed a cellular type extraskeletal myxoid chondrosarcoma of the lower left mandible. Under general anaesthesia, the patient underwent lower left mandibular block and segmental resection, submandibular triangle dissection and vessel disassociation, and musculocutaneous flap repair in the oral and maxillofacial defect area. After 9 months of follow-up, the patient had no complaints of discomfort, and tumour recurrence was not observed on imaging examinations.

Keywords: extraskeletal myxoid chondrosarcoma; mandible; soft tissue.

Figure 1.

(A) Preoperative panoramic radiograph. A hypodense shadow is visible at the mesiodistal area near the root of tooth 34 and the mesiobuccal area of tooth 35. (B) Preoperative image of the patient's mouth. A buccal gingival tumour is visible (teeth 34 and 35), sized 3×2 cm, with a dark red colour. (C) Panoramic radiograph of the patient 1 week after surgery. Following lower left mandibular block and segmental resection, the positions of the bone graft and titanium were stable.

Figure 2.

(A) Macroscopic image of the surgical specimen. The tumour was cystic, with a grey jelly-like surface. On microscopic examination under a light microscope (B) the tumour capsule was intact [hematoxylin and eosin (H&E) staining; magnification, ×100], (C) the tumour was divided into nodules by fibrous tissue bands (H&E staining; magnification, ×100) and (D) myxoid matrix was observed between cells (H&E staining; magnification, ×200).