AN UNUSUAL MESENCHYMAL MALIGNANT TUMOR OF MANDIBLE A CASE REPORT

Mesenchymal Chondrosarcoma MC is an unusual malignant tumor of bone or soft tissue.MC of the jaw occurs in second or third decade of life and demonstrates a more indolent behaviour compared with lesions from other anatomic locations. MC is a rapidly growing tumor thatmetastasizes hematogenously. MC are known for local recurrence. Surgical resection is the mainstay of treatment with adjuvant radiotherapy or chemotherapy. Radiotherapy is given for unresectabletumors or residual tumors. Patients with localized disease with no evidence of spread to other siteshave a good prognosis with radical surgical resection. Typical presentation is with swelling, pain andother symptoms related to location of the tumor. Even after surgical resection MC can recur as late as20 years therefore careful follow up is mandatory.We report a case of 17 year old-female presented with a MC of the left mandible confirmed with a core needle biopsy from the lesion. She underwent awide local excision of the lesion with a free fibular flap reconstruction. Biopsy of the resected leftlower alveolar specimen revealed lobules of hyaline cartilage along with nests, clusters and sheets ofsmall cells with hyperchromatic, mitotically active nuclei and scanty cytoplasm that was consistentwith MC. The medial mucosal resection margin and posterior soft tissue margins were involed withtumor. A whole body planning PET-CT scan done 3 weeks post- operatively revealed residualdisease at the post-operative site for which she was treated with adjuvant RT. At 6 months follow upclinically and on imaging there is no evidence of locally active disease or disease in progression .