Chondrosarcoma of the hyoid bone: an atypical site of a sarcoma of the head and the neck

Abstract

We describe a case of a 73-year-old man with a chondrosarcoma of the hyoid bone. The patient presented with a painless palpable lump in the upper anterior cervical region that had been growing for over 10 months. Fine-needle aspiration cytology suggested pleomorphic adenoma but further imaging investigation with CT revealed an exophytic tumour originating from the body of the hyoid bone with prominent chondroid-like calcifications typical of a chondrosarcoma. Histopathology of the surgical specimen confirmed the diagnosis of a moderately differentiated chondrosarcoma. Chondrosarcomas account for 11% of all bone cancers, of which up to 12% are in the head and neck. Primary sites of the head and the neck include the skull base, the nasal cavity, the maxilla, the mandible and the larynx. Chondrosarcomas of the hyoid bone are exceptionally rare, with only 20 such cases previously reported in the English literature.

Diagnostic use of fine‐needle aspiration cytology and core‐needle biopsy in head and neck sarcomas

“…Chondrogenic malignancies represent one of the most difficult cytological diagnosis, particularly distinguishing benign chondromas from low‐grade chondrosarcomas 38,39 . In the salivary glands, these tumors are commonly misdiagnosed as pleomorphic adenomas with chondroid differentiation 40 . Moreover, FNAC's correlation with final histology was significantly lower for tumors of uncertain differentiation.…”

Condrosarcoma del hueso hioides: a propósito de un caso

“…Suponen el 11% del total de cánceres óseos primarios y típicamente asientan en pelvis, costillas y huesos largos 1,2 . Su aparición en cabeza y cuello es de tan solo el 1%-12% de los casos 1 , siendo, en estas localizaciones, más frecuente en la base del cráneo, cavidad nasal, maxilar, mandíbula y esqueleto laríngeo 2,3 . La aparición de un condrosarcoma en el hueso hioides es extremadamente rara aunque deben tenerse en cuenta como diagnóstico diferencial de una masa submandibular 4 .…”

“…La presentación clínica más habitual suele ser una masa indolora en la región central del cuello 2,3,6 , lo que se corresponde con el caso descrito. El TC de cuello es útil demostrando las calcificaciones características y la rotura de la cortical ósea.…”

Scapula chondrosarcoma

“…MRI is optimal for delineating soft tissue involvement, and due to high water content in the matrix, tumor show very high signal intensity on T2-weighted images, which are an assessment of whether tumor cells have invaded the soft tissue to guide surgical treatment. [12] Positron emission tomography (PET) scanning with 18-fluorodeoxyglucose (FDG) is unreliable when distinguishing benign from malignant chondrogenic lesions, identifying metastatic disease, or distinguishing recurrent tumors from postoperative changes due to the low metabolic activity of low-grade tumors. However, PET can be useful in identifying high-grade chondrosarcomas that show increased standardized uptake values (SUVs) due to higher glucose metabolism.…”