AN UNUSUAL MESENCHYMAL MALIGNANT TUMOR OF MANDIBLE A CASE REPORT

Abstract

Mesenchymal Chondrosarcoma MC is
an unusual malignant tumor of bone or
soft tissue.MC of the jaw occurs in second
or third decade of life and demonstrates
a more indolent behaviour compared
with lesions from other anatomic
locations. MC is a rapidly growing tumor
thatmetastasizes hematogenously. MC
are known for local recurrence. Surgical
resection is the mainstay of treatment
with adjuvant radiotherapy or chemotherapy.
Radiotherapy is given for unresectabletumors
or residual tumors. Patients
with localized disease with no evidence
of spread to other siteshave a
good prognosis with radical surgical resection.
Typical presentation is with
swelling, pain andother symptoms related
to location of the tumor. Even after
surgical resection MC can recur as late
as20 years therefore careful follow up is
mandatory.We report a case of 17 year
old-female presented
with a MC of the left mandible confirmed
with a core needle biopsy from the lesion.
She underwent awide local excision of the
lesion with a free fibular flap reconstruction.
Biopsy of the resected leftlower alveolar
specimen revealed lobules of hyaline cartilage
along with nests, clusters and sheets
ofsmall cells with hyperchromatic, mitotically
active nuclei and scanty cytoplasm
that was consistentwith MC. The medial
mucosal resection margin and posterior
soft tissue margins were involed withtumor.
A whole body planning PET-CT scan done
3 weeks post- operatively revealed residualdisease
at the post-operative site for
which she was treated with adjuvant RT. At
6 months follow upclinically and on imaging
there is no evidence of locally active disease
or disease in progression