Mesenchymal chondrosarcoma of maxilla misdiagnosed as a benign fibrous lesion: A rare case report from Syria.

Abstract

Introduction: Mesenchymal chondrosarcoma (MC) is a high-grade variant of chondrosarcoma, essentially composed of poorly differentiated spindle cells interspersed with areas of cartilage or chondroid matrix. MC is extremely rare; it only accounts for 0.1 % of head and neck tumors and for only 1 % of all chondrosarcomas (CSs).

Case presentation: A 21-year-old man presented with a medical history of a painful irritation at the dextral maxillary region, presented as a mass at the vestibule of the oral cavity near the upper molars, and had been misdiagnosed as a benign fibrous lesion and excised without performing a biopsy. Magnetic resonance imaging (MRI) revealed an invasive lesion filling the right maxillary sinus and penetrating the orbital floor. A biopsy was then performed and revealed an MC.

Clinical discussion: The patient underwent a wide surgical resection, except for the infraorbital region, in which the tumor was surrounded by a fibrous capsule separating it from the anatomical structures of the eye. Due to the lack of wide resection in the orbital floor area (to preserve the eyeball), we applied the chemotherapy that was done with cisplatin and doxorubicin.

Conclusion: Confirmed diagnosis by biopsy and treatment, both surgical and chemical, with frequent follow-up are decisive factors in progressing MC.