Chondrosarcoma of the mandible involving angle, ramus, and condyle.
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.
Department of Oral and Maxillofacial Surgery, SonEspases Hospital, Palma de Mallorca, Spain. ramosmurg@gmail.com
Mikel
M
Ramos-Murguialday
Victor
V
Lasa-Menéndez
Jose
J
Ignacio Iriarte-Ortabe
Marta
M
Couce
D002813:Chondrosarcoma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000473:pathology / Q000601:surgery; D008339:Mandibular Neoplasms / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy; D019651:Plastic Surgery Procedures / Q000379:methods*