Chondrosarcoma of mandible: a case report
A 36 year old male patient reported with a chief complaint of swelling involving the right side of face for about 8-9 months. Extra orally, there was presence of a medium sized, firm to hard, slightly tender swelling with ill-defined margins involving the right side of mandible. Overlying skin appeared normal. Intraoral examination revealed the presence of firm, lobular, slightly tender central mandibular swelling in relation to right -premolar-molar region, associated with expansion of both the cortical plates.

Egg-shell crackling was evident over some areas of the buccal cortical plates. The regional teeth were displaced and mobile while the overlying mucosa had a normal appearance. Orthopantomogram (dental panoramic radiograph) revealed a large, ill-defined central jaw lesion showing mixed radiographic changes, and characterized by marked alveolar bone destruction, resorption of the mesial root of first molar tooth and thinning of the lower border of the mandible.

Based on the above clinical and radiological findings, an incisional biopsy was performed from the representative site of the lesion. The light microscopic features revealed the presence of a proliferated mass of cartilaginous tissue showing marked cellular and nuclear pleomorphism with nuclear hyperchromatism.

After considering these microscopic features, a diagnosis of 'High grade Chondrosarcoma' was established and a plain coronal CT scan was advised, which revealed the presence of a large fairly defined osteolytic lesion showing sun-ray appearance and expansion of the cortical plates. These findings were strongly corroborative to the microscopic diagnosis.

The patient was advised to go for surgical treatment. A wide field radical surgery (segmental mandibulectomy with supra-omohyoid block dissection of neck) was performed under general anethesia. Post-operative period up to 6 months was uneventful and after that the patient did not report back for further follow-ups at an interval of 6 months. The histopathology of the resected specimen also revealed the characteristic confirmative features of "High Grade Chondrosarcoma."

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Dr. B●●●●●h K●●●r S R and 1 others like this
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