Maxillary chondrosarcoma: a case report

Chondrosarcoma is a malignant tumor of cartilaginous origin, which is rarely seen in the maxillofacial region, especially in young individuals. The most common clinical manifestation is painless swelling of the bone. The anterior maxilla and the posterior mandible are considered the most common sites of occurrence, with a slightly higher incidence reported in female compared with male individuals. Chondrosarcomas typically present in older individuals, most commonly during the fourth to sixth decades of life. The most widely accepted treatment approach for this tumor is radical surgery (Jundishapur Sci Med J 12(5):621-7, 2013; Acta Oto-Laryngol Case Rep 9(1):68-75, 2024). A 33-year-old Iranian woman presented to the Department of Oral and Maxillofacial Surgery at Yazd Dental School with swelling in the left maxillary region, which had progressed over the past year. In her medical history, the patient had a history of hypothyroidism, for which the medications were discontinued by the physician 9 years ago. The patient also had a previous diagnosis of chondrosarcoma 10 years earlier. She underwent surgery, followed by 35 sessions of radiotherapy and 17 sessions of chemotherapy radiotherapy. Vital signs at presentation were within normal limits. Radiographic evaluation revealed a radiopaque lesion with ill-defined borders in the left maxilla, extending from the region of the upper left canine (tooth no. 23) to the first molar (tooth no. 26), and vertically from the alveolar crest of the edentulous area to the inferior border of the nasal cavity. The lesion caused expansion of the buccal and lingual plates, the alveolar crest, and the inferior border of the nasal cavity. Microscopic examination showed histopathologic features consistent with chondrosarcoma, along with areas of metaplastic bone formation, leading to a diagnosis of grade 2 chondrosarcoma. The lesion was resected with an average safe margin of 5 mm, including the underlying bone. The 6-month follow-up showed no evidence of recurrence. This report presents a case of recurrent chondrosarcoma in the maxilla of a young woman and discusses the diagnostic challenge with chondroblastic osteosarcoma. It emphasizes the need for long-term follow-up in managing this malignancy.