Chondrosarcoma
Chondrosarcoma is a malignant tumor of mesenchymal origin that
.produces cartilage
:Clinical Features
.Age: adults 47 mean age
.Sex: males and females equally
:Symptoms
pain-1
headache-2
hemorrhage from tumor or from teeth-3
sensory nerve defect-4
proptosis and visual disturbances -5
.trimus or abnormal joint function -6
:Imaging features
.Location:-10% in facial bone in all cases
.maxilla and mandible are equal.In maxilla :anterior region-In mandible : occur in coronoid process ,condylar head and neck,
.symphyseal region
:Periphery and shape
:Two types of lesions
.slow growing tumors :shape :round ,ovoid or lobulated_1
Periphery :well defined ,corticated may meld with normal bone or be
perpendicular to the orginal cortex giving sunray or hair end
.appearance
.aggressive lesion :ill defined , invasive ,infiltrative ,non corticated -2
.
:Internal structures
Some calcification within the center called
flocculent so it is mixed radiolucent
.radiopaque appearance
:Some names to this appearance
moth eatensnow like featuresGranular or ground glass appearing of.abnormal bone
Irregular
calcification
Chondrosarcoma in the condyle, areas of
bone destruction and some calcification
:Effect on surrounding structers
Slow growing often expand normal cortical boundries rather
.than rapidly destroying them. Displace and resorp teeth
:Differential diagnosis
osteosarcoma: typical calcification of chondrosarcoma may - 1
.be absent
fibrous dysplasia: the periphery is better defined and it alter-2
.lamina dura leaving thin PDL space
:Management
.Surgical excision
Ewing sarcoma
.Rare small round tumor of neuroectodermal origin
:Clinical features
Age: between 5 and 30 years
Sex:males twice as females
Symptoms: swelling ,pain ,loose teeth, paresthesia,
exophthalmos, ptosis,epistaxis , ulceration, shifted teeth,
.trismus ,cervical lymphadenopathy and sinusitis
:Imaging features
Location: rare, mandibular cases twice as maxilla
.,in posterior areas in both jaws
Periphery and shape: not corticated ,ragged border,
solitary , may cause pathologic fracture ,no
.typical shape
.Internal structures : destructive mostly ,radiolucent
:Effect on surrounding structures
Not common feature that periosteal new bone-1
.formation in jaws compared to other sites
mandibular neurovascular canal, inferior border of-2
.mandible are effected
Does not cause root resorption but destroy the-3
.supporting bone of adjacent teeth
:Differential diagnosis
:Inflammatory lesions such as osteomyelitis-1
Sequestra that found on it not present in ewing sarcoma,
Inflammatory lesions have reactive bone formation but it
.differ from periosteal bone formation
Eosinophilic granuloma associated with laminar periosteal-2
bone formation whereas Ewing sarcoma in jaws does not have
.this feature
Difficult to differentiate from chondrosarcoma, fibrosarcoma-3
.and osteosarcoma
:Management
.Surgery, radiation therapy, chemotherapy
Ewing sarcomain left mandibular condyle ,irregular margin,
.destruction of the medial cortex of the condyle and pathologic fracture
Fibrosarcoma
Fibrosarcoma composed of malignant fibroblast that produce collagen
.and elastin
.Etiology: unknown ,may because of radiation
:Clinical features
.Age: mean age fourth decade
.Sex: equally in males and females
:Symptoms
.slowly to rapidly enlarging massif in bone accompanied with pain and invade soft tissues so it appear .bulky and mucosa become ulcerated
.pathologic fractures may occur.sensory neural abnormalitiestrismus.
:Imaging features
Location : mostly in mandible especially in the premolar molar
.region
:Periphery and shape
.ill defined noncorticated ragged border .infiltrative so may underestimated in radiogragh .in soft tissue lesion saucer like shape in bone or invade as SCC .sclerosis in adjacent normal bone-
:Internal structures
Little internal structures,Radiolucent mostly but may
.have bone formation if not aggressive
:Effect on surrounding
Destruction to alveolar process, inferior border, cortex.of neurovascular canal ,walls of the sinus ,nasal floor
teeth: displaced grossly , no root resorption, obliterated.lamina dura, floating teeth
.periosteal reaction uncommon-
Differential dignosis
If fibrosarcoma does not cause enlargement rule out Multiple myeloma and intraosseous carcinoma
.,infected cyst
If exhibit enlargement and tissue mass rule out chondrosarcoma , osteosarcoma and central
.desmoplastic fibroma
Ewing sarcoma and radiolucent osteosarcoma Difficult.to differentiate from this tumer
Peripheral invasive SCC have ulcerative surface while.fibrosarcoma does not
:Management
.Chiefly surgical ,radiation and chemotherapy palliative tt
Fibrosarcoma in right maxillary sinus has destroyed cortical
boundaries of the sinus ,zygomatic process, hard palate
.,posteior maxilla and alveolar process
Thank you
Name: Hawra Makki Hilal
Student number:20102050087
