Chondrosarcoma of the Mandible Involving Angle, Ramus, and Condyle

Abstract

Chondrosarcomas (CHSs) are malignant tumors of cartilaginous origin rarely found in the jawbone. Only 5% to 10% of CHSs occur in the head and neck region. These tumors have strong tendency to recur locally after surgical removal. Here, we present the case of a 45-year-old man with a CHS of the mandible. We describe the removal of the mandibular condyle, which requires the reconstruction of the temporomandibular joint. This raises the difficulty of reconstruction because of the location of the tumor in a region of great aesthetic and functional impact. In our case, the patient with computed tomography scan had a mandibular osteolytic and expansive multilocular lesion located in the mandibular branch and left mandibular angle involving the condyle. A biopsy revealed a moderately differentiated CHS (World Health Organization grade II). We decided to perform a wide surgical excision of the lesion without neck dissection because of the infrequent lymphatic spread. It was carried out with a left mandibulectomy, including the mandibular condyle. The reconstruction was performed by using a microsurgical fibula flap and fixing it to the meniscus and articular capsule with a Mitek anchor. The patient has no clinical signs of recurrence or aesthetic or functional limitations 3 years after surgery. This case has brought us to review a very uncommon matter in this location, which emphasizes the importance of a wide resection crucial in the disease prognosis.

Temporomandibular joint chondrosarcoma: a case report and literature review

“…Therefore, chondrosarcoma of the jaw is uncommon in the head and neck, but when present, it and primarily occurs at the anterior maxilla in the head and neck area or in the nasal cartilage. Chondrosarcoma in the temporomandibular joint (TMJ) area is exceptionally rare, and only 30 cases have been reported in the literature234567891011121314151617181920212223242526272829303132333435363738. Treatment of chondrosarcoma of the TMJ is often challenging and might be related to the presence of associated vital structures, which include the facial nerve, parotid gland, and the close proximity to the cranial base.…”

Chondrosarcoma of the Temporomandibular Disc: Behavior Over a 28-Year Observation Period

“…Chondrosarcoma has been further classified histologically into clear cell, myxoid, dedifferentiated, and mesenchymal variants. 22,34 To date, 8 of the TMJ chondrosarcomas in the literature-including the present case-have been grade I lesions 12,15,18,23,24,26,27 and 1 grade II lesion 28 ; none of the remaining reporters have used this classification.…”

Imaging features of chondrosarcoma of the temporomandibular joint: report of nine cases and literature review

“…From 1954 to 2019, 40 cases of chondrosarcoma of the TMJ were reported in the English literature (Table 3). 4e16,19e42 Although there were some more cases of chondrosarcoma arising in the mandibular condyle, 46e51 they were not included in the present literature review, because one occurred in the ramus and only extended below the condylar neck 46 and the others were from non-English literature 47,48,51 or could not be searched online and offline. 49,50 The ages of the reviewed patients ranged from 7 to 78 years (mean, 46.3 years), and the ratio of male to female patients was 14:23.…”