Chondrosarcoma of maxilla - A rare case report

Abstract

Rationale: Chondrosarcoma, although being a rare entity in jaws, may turn fatal if left untreated or inadequately excised. Prognosis in terms of 5-year survival rate ranges from 90% for Grade I, 81% for Grade II and 43% for Grade III respectively. Patient Concerns: A 35-year-old male patient reported with a gradually progressive hard painless growth over right maxillary molar region. His main concern was removal of pathology without long-term morbidity. Diagnosis: Computed tomography revealed ill-defined mass with internal calcification involving posterior half of upper right alveolus. Treatment and Outcomes: Mandatory biopsy suggested benign chondroma, however wide excision and infrastructural maxillectomy revealed Grade II chondrosarcoma. Take-away Lessons: Complex anatomy of maxilla renders surgical excision of chondrosarcomas with histological clear margins, a daunting task. Due to misdiagnosis of preoperative biopsy, suboptimal excision of malignant mass may lead to local recurrence and occasional distant metastasis. This necessitates further therapy and long term follow up, with occasional poor patient compliance.

Chondrosarcoma of the maxilla

“…Grade 3 chondrosarcomas display a myxoid matrix with irregularly shaped chondrocytes and increased cellularity, nuclear pleomorphism, and mitoses compared with the low-grade chondrosarcomas 5. In chondrosarcoma, bone formation takes place on framework of pre-existing cartilage matrix; whereas in osteosarcoma, it is directly by the malignant stromal cells 6. Enchondroma’s histological appearance may resemble grade 1 chondrosarcoma.…”