Satya Ranjan Misra et al 78 JAYPEE CASE REPORT Mesenchymal Chondrosarcoma of the Jaws: A Series of two Rare Cases Satya Ranjan Misra, G Maragathavalli, Vineet Daniel Alex, Sobhan Mishra ABSTRACT Chondrosarcoma (CS) is a malignant neoplasm that results in abnormal bone and cartilage growth. Although CS is rare, it is the second most common primary bone malignancy. Mesenchymal chondrosarcoma (MC) is a rare histological variant of CS that accounts for only about 1% of all CS and has high predilection for the head and neck region. It is usually seen in younger age group compared to conventional CS and the maxillary alveolus is the most common site. The tumor is unique because of its aggressive growth with a high tendency for late recurrence and delayed metastasis. We present two cases of MC, one case involving the mandibular condyle and the second, a metastatic CS with the primary in the clavicle. Keywords: Chondrosarcoma, Mesenchymal chondrosarcoma, Metastasis. How to cite this article: Misra SR, Maragathavalli G, Alex VD, Mishra S. Mesenchymal Chondrosarcoma of the Jaws: A Series of two Rare Cases. J Indian Aca Oral Med Radiol 2012;24(1):78-82. Source of support: Nil Conflict of interest: None declared CASE REPORTS Case 1 A 22-year-old male patient reported to the dental hospital with the complaint of a swelling on the right side of the face since the past 2 months. History revealed that the swelling has been progressively growing in size over the period of 2 months. An ulcer developed in the right buccal mucosa about 1 month back which did not heal with medications. The patient had a restricted mouth opening and numbness in the right side of the lower lip since last 15 days. On examination, a diffuse swelling was seen causing facial asymmetry on the right side of the face, ovoid in shape, measuring 7 × 6 cm in size. The swelling was firm in consistency, fixed to the underlying bone and nontender on palpation. No secondary changes of ulcer or sinus were seen and there was no discharge. Intraorally, an ulceroproliferative growth was seen in the right retromolar region extending anteriorly upto 45, measuring about 3 × 3 cm, the ulcer was covered with slough, with irregular margins. It was indurated and tender on palpation. There was no discharge from the ulcer, surrounding area firm in consistency with bicortical expansion of the mandible in the 45 to 47 region. A provisional diagnosis of a malignant bony neoplasm was given (Fig. 1). 10.5005/jp-journals-10011-1265 Panoramic radiography revealed decreased radiodensity in the right ramus, with erosion of the condylar outline. There was a typical ‘sunburst’ appearance in the condyle extending up to the angle of the mandible on the right side (Fig. 2). CT scan revealed osteosclerosis and erosion of the condyle extending upto the ramus, a nonenhancing mass with mottled calcifications was seen in the axial sections measuring 6.4 × 6.5 cm. The classic ‘sunburst’ appearance is also seen. The coronal images also show extension of the involvement of the marrow space (Figs 3 and 4). An incisional biopsy was then done; histological examination revealed highly cellular connective tissue stroma with formation of large amounts of chondroid matrix (Fig. 5). The nuclei of the chondrocytes were large and pleomorphic with an open chromatin pattern (Fig. 6). Fig. 1: Ulceroproliferative growth was seen in the right retromolar region Fig. 2: Sunburst appearance in the condyle extending up to the angle of the mandible