Presentation
Three months history of progressive painful swelling of the left maxillary region.
Patient Data
A relatively well-defined periosteal soft tissue mass of the left paramedian maxillary region arising from the periosteum, containing punctate and arcs calcification with moderate heterogeneous enhancement on postcontrast images, displacing the orbicularis oris and levator labii superior muscles. Mid cortical erosion with no destruction of the adjacent cortical bone of maxilla.
Note diffusely enlarged thyroid gland with heterogeneous enhancement (most likely thyroiditis).
Postoperative CT scan was done 2 months after complete surgical resection of the tumor.
No recurrence was seen within the operative site or distant thoracic or abdominopelvic metastasis.
Case Discussion
Case of chondroblastic osteosarcoma (histologically proven).
Craniofacial osteosarcoma is a relatively rare entity. The average age of onset is in the 4th decade. The common presentation is a rapidly growing painful swelling. The most frequent locations are alveolar ridge and antrum, and mandible.
CT and MRI are the modalities of choice to detect the bone involvement, tumor calcifications as well as the invasion of the adjacent soft tissues.
The presence of predominant cartilaginous component within the tumor can be the origin of a diagnostic dilemma nevertheless, the immunohistochemistry (IHC) study can play an important role to differentiate chondrosarcoma from a chondroblastic variant of osteosarcoma. Radical surgery is the mainstay of treatment.