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Choi YJ, Han SS, Lee C, Jeon KJ. CT and MR imaging findings of head and neck chondrosarcoma. Oral Radiol 2024; 40:242-250. [PMID: 38108955 DOI: 10.1007/s11282-023-00729-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/18/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES This study investigated the imaging features of head and neck chondrosarcoma (HNCS) according to its origin and pathologic subtype. METHODS Patients who were pathologically diagnosed with HNCS between January 2000 and April 2022 were retrospectively reviewed. Lesions were classified based on their origin and pathologic subtype. The size and margin were evaluated on the image. Internal calcification and the effects on adjacent bone were assessed using computed tomography (CT) images, while signal intensity and contrast enhancement patterns were analyzed using magnetic resonance (MR) imaging. RESULTS Thirteen HNCSs were included in this study: 8 bone tumors (61.5%) and 5 soft tissue tumors (38.5%). The bone tumors were pathologically diagnosed as conventional (n = 5) and mesenchymal type (n = 3). Soft tissue tumors were defined as myxoid type. The main symptoms were swelling (90.9%) and pain (72.7%). The lesions measured 4.5 cm on average. The margins showed benign and well-defined except for the mesenchymal type. On CT, most bone tumors (75%) showed internal calcification with remodeling or destruction of the adjacent bone. No soft tissue tumors, except one case, showed internal calcification or destruction of the adjacent bone. MR imaging features were non-specific (T2 high signal intensity and contrast enhancement). CONCLUSIONS HCNS showed various imaging findings according to their origin and pathologic subtype. HNCS should be differentiated if a bone tumor shows internal calcification and affects the adjacent bone. When diagnosing slow-growing soft tissue tumors, even if low possibility, HNCS should be considered.
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Affiliation(s)
- Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea.
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Dabas SK, Menon NN, Ranjan R, Gurung B, Tiwari S, Bassan BB, Shukla H, Pasricha S, Sinha A, Kapoor R, Verma VK, Verma D, Arora S, Sharma A, Mukharjee S, Singal R, Fernandes TB. Extraskeletal Myxoid Chondrosarcoma of Floor of Mouth-A Rare Case Report and Review of Literature. Indian J Otolaryngol Head Neck Surg 2024; 76:1290-1297. [PMID: 38440485 PMCID: PMC10908772 DOI: 10.1007/s12070-023-04271-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/05/2023] [Indexed: 03/06/2024] Open
Abstract
Introduction Chondrosarcomas are rare malignancies of the cartilage and myxoid chondrosarcoma is its variant which commonly occurs in soft tissue of extremities. Extraskeletal chondrosarcoma is a rare malignant neoplasm of bone or soft tissue origin and is characterized by the presence of spindle cells admixed with well differentiated cartilage or chondroid stroma. They are mostly radioresistant tumours and surgical resections with adequate margins is considered as the ideal treatment modality with adjuvant radiotherapy in high grade tumours and add on chemotherapy, in case of presence of poor prognostic factors. Case Report A 51-year-old diabetic, hypertensive female patient presented to our outpatient department with difficulty in chewing food for a duration of 6 months. On clinical examination, she had an ulceroproliferative growth involving right lower alveolus and floor of mouth. MRI face and neck with contrast showed a 4.1 × 2.9 × 4.5 cm lesion involving right lower alveolus extending to floor of mouth. Biopsy showed features of extraskeletal myxoid chondrosarcoma. She was planned for upfront surgery (Right composite resection with modified radical neck dissection with free fibula flap). Patient was stable post-surgery and was discharged in stable condition. Final histopathology report was high grade myxoid chondrosarcoma. The case was presented in tumour board and the patient was planned for adjuvant radiotherapy. She has been on regular follow up for the past 2 years and shows no signs of recurrence. Conclusion Extraskeletal myxoid chondrosarcoma of oral cavity is a rare entity and very few cases are reported. It is a malignant neoplasm which is diagnosed with the help of immunohistochemistry. Surgery is the ideal modality of treatment accompanied by adjuvant radiotherapy in cases of high-grade tumours.
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Affiliation(s)
- Surendra K Dabas
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Nandini N Menon
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Reetesh Ranjan
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Bikas Gurung
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Sukirti Tiwari
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Bharat Bhushan Bassan
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Himanshu Shukla
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Sunil Pasricha
- Pathology Department, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Ajit Sinha
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Rahul Kapoor
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Vinay Kumar Verma
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Devesh Verma
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Saurabh Arora
- Department of nuclear medicine, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Ashwani Sharma
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Sourabh Mukharjee
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Rishu Singal
- Department of Radiodiagnosis, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - Trishala Bhadauria Fernandes
- Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, Delhi, 110005 India
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Li J, Zheng Z, Deng H, Men Y, Chen Y, Han Q. Extraskeletal myxoid chondrosarcoma of the gingival: a rare case report and review of the literature. Diagn Pathol 2023; 18:103. [PMID: 37705036 PMCID: PMC10498572 DOI: 10.1186/s13000-023-01390-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 09/03/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Extraskeletal myxoid chondrosarcoma (EMC) is a rare malignant tumor described in the head and neck region, especially in the gingival. We present one case arising in the gingival of right mandible, and briefly reviewed the related literature. CASE PRESENTATION A 24-year-old male patient with a lesion of 3.5*2.0 cm in buccal gingival of right posterior mandible for 2 months. The tumor was composed of cartilaginous structures and myxoid matrix. Immunohistochemical(IHC) showed that the tumor cells to be positive for vimentin, focally positive for S-100, negative for calponin, SMA, SOX10. The Ki-67 labelling index was 80%. Fluorescent in situ Hybridization (FISH) was positive for NR4A3 rearrangement. CONCLUSIONS Due to its unusual site and low incidence in the oral region, a combination of histological findings, immunohistochemistry, and molecular pathology as well as differential diagnosis with other diseases should be taken into consideration in the process of clinical diagnosis and treatment.
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Affiliation(s)
- Jiaqi Li
- State Key Laboratory of Oral Diseases &, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
- State Key Laboratory of Oral Diseases &, Department of Oral Pathology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Zhijian Zheng
- State Key Laboratory of Oral Diseases &, Department of Oral Pathology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Hao Deng
- State Key Laboratory of Oral Diseases &, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
- Department of Stomatology, The First People's Hospital of Ziyang, Ziyang, 641300, P.R. China
| | - Yi Men
- State Key Laboratory of Oral Diseases &, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
- State Key Laboratory of Oral Diseases &, Department of Head and Neck Oncology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Yu Chen
- State Key Laboratory of Oral Diseases &, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China.
- State Key Laboratory of Oral Diseases &, Department of Oral Pathology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China.
| | - Qi Han
- State Key Laboratory of Oral Diseases &, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China.
- State Key Laboratory of Oral Diseases &, Department of Oral Pathology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China.
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Fidele NB, Tianfu W, Liu B, Sun Y, Yifang Z. Extraskeletal Myxoid Chondrosarcoma of the Parotid Gland. Ann Maxillofac Surg 2020; 9:439-443. [PMID: 31909032 PMCID: PMC6933961 DOI: 10.4103/ams.ams_145_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Extraskeletal myxoid chondrosarcoma (EMC) is a rare tumor with an estimated incidence of <3% among of all soft-tissue sarcomas. It is characterized by a multinodular architecture, abundant myxoid matrix, and malignant chondroblast-like cells arranged in cords. The tumor is an entity from chondrosarcomas of bones, commonly found in the soft tissues of the lower extremities at 80%. There are very limited reports of this tumor in the head and neck, especially in the parotid gland. The purpose of this paper is to describe an EMC located at an unusual site in the parotid gland, and briefly, the literature review with special reference to the clinicopathological features and the treatment approach was discussed.
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Affiliation(s)
- Nyimi Bushabu Fidele
- Department of Oral Maxillofacial Head and Neck Oncology Surgery, School and Hospital of Stomatology, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Oral and Maxillofacial Surgery, Teaching Hospital of Kinshasa University, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Wu Tianfu
- Department of Oral Maxillofacial Head and Neck Oncology Surgery, School and Hospital of Stomatology, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bing Liu
- Department of Oral Maxillofacial Head and Neck Oncology Surgery, School and Hospital of Stomatology, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yanfang Sun
- Department of Oral and Maxillofacial Surgery, Teaching Hospital of Kinshasa University, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Zhao Yifang
- Department of Oral and Maxillofacial Surgery, Teaching Hospital of Kinshasa University, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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