PP121: Chondrosarcoma of the head and neck: A case report

Abstract

Introduction Chondrosarcoma is an unusual neoplasm in head and neck, characterized by the formation of cartilage. Material and methods 27 years old female with neurofibromatosis-1 presents a solid tumor in maxilla which has increased during last two months without symptoms. We took a biopsy and histology was mesenchymal chondrosarcoma, so we planned the surgical treatment. Results We performed a left hemimaxilectomy type IIb (Brown and Shaw classification) and we reconstructed the defect with a fibula free flap. Histological exam confirmed the diagnosis and free margins. The patient received adjuvant radiotherapy and after 9 months of follow up she presents good adaptation of the fibula free flap, an excellent oral mucosa metaplasia without recurrences. Conclusion Chondrosarcoma represents 10–20% of all primary malignant bone tumours, but head and neck location is unusual ranging from 5% to 12% and only 0.1% of head and neck malignant tumours. It affects young people and the most frequent presentation is a painless swelling in the anterior maxilla. There are five different histological types: conventional, secondary, dedifferentiated, clear cell and mesenchymal. Our patient showed a mesenchymal chondrosarcoma which is always considered a high grade tumour. Metastasis appear in lungs but it not usually show up in neck lymph nodes. The most effective treatment is aggressive surgery with wide margins, also adjuvant treatment with radiotherapy and chemotherapy could be used in those patients but do not appear to have a significant effect on survival. Head and neck chondrosarcoma is a very rare neoplasm, It affects young people and presents different grades of malignancy depending on the histological type. Despite of the histology, the only really effective treatment is surgery, performing a wide margins resection and an appropriate reconstruction.