Primary chondrosarcoma arising in the parotid gland

Primary maxillary chondrosarcoma: A case report

BACKGROUND

Sarcomas of the head and neck region are rare tumors, constituting less than 1% of malignant neoplasms in this area, of which few cases (20%) originate from bone or cartilage. Chondrosarcoma is a malignant neoplasm that develops in bone, with a predilection for the pelvis, chest wall, and scapula, and is uncommon in the maxilla and jaw. Although this type of lesion has locally aggressive behavior, destroying the affected bone, it can metastasize when it is not diagnosed early and compromise the patient's life.

CASE SUMMARY

On intraoral examination of a 32-year-old female with a tumor in the middle third of the face, a well-defined rise in volume of approximately 3 cm in diameter was observed. Computed tomography with 3-dimensional reconstruction was performed, and we observed that the osteolytic lesion affected the vestibular cortex as the palatal bone. Hematoxylin and eosin staining revealed an appearance that was similar to mature hyaline cartilage, hypercellularity, nuclear and cellular pleomorphism, and multinucleated cells, with significant vacuolization.

CONCLUSION

Determination of the clinical and histopathological characteristics of rare neoplasms in the maxillofacial region, such as chondrosarcomas, allows the pathologist and surgeon to make the appropriate therapeutic decisions, optimizing the patient’s prognosis.

A rare case of chondrosarcoma arising in parotid with extension to lateral skull base

Chondrosarcomas of head and neck region are rare. Very few cases of chondrosarcomas arising in parotid gland have been reported and none with intracranial extension. We report a case of a female presenting with a parotid swelling and a mass in external auditory canal with extradural extension to posterior cranial fossa. With a preoperative fine needle aspiration diagnosis of pleomorphic adenoma, it was excised and the histopathology came out to be low-grade myxoid chondrosarcoma. She has not received any adjuvant chemoradiotherapy and there is no evidence of recurrence at months.

Parotid gland chondroma masquerading as pleomorphic adenoma in fine needle aspiration cytology: A diagnostic challenge

Chondroid neoplasm of parotid gland is extremely rare. Only a few cases of extraskeletal chondroma and one case of chondrosarcoma of parotid gland have been reported in the literature. The cytological features of parotid gland chondroma are not well documented. A 61-year female patient presented with a slow growing left preauricular mass for past 6 years. Computer tomography scan showed a well circumscribed mass in the superficial lobe of left parotid gland. Fine needle aspiration cytology (FNAC) showed uniform chondrocytes embedded in a chondroid matrix, and was diagnosed as pleomorphic adenoma. Histological examination of the excised specimen showed a benign cartilaginous tumor, consistent with chondroma. There was no epithelial or myoepithelial component on extensive search. Chondroma is an extremely rare tumor of parotid gland and can be misdiagnosed as pleomorphic adenoma on cytology examination. However, absence of epithelial and myoepithelial component can give a clue toward a pure chondroid neoplasm. This report highlights the diagnostic features of chondroma of parotid gland and its diagnostic pitfalls in FNAC.

[Calcifications of the parotid space. A review]

INTRODUCTION

Parotid lithiasis is the main cause of calcifications in the parotid space. However, there are many other less known causes. The aim of our study was to point out the non-lithiasic causes of calcifications in the parotid space.

MATERIAL AND METHODS

We conducted an exhaustive review of the literature by mean of PubMed, using the keywords "parotid" and "calcification" and limiting our analysis to the original articles in humans published in English and in French. Articles reporting about microscopic calcifications and who were not dealing with parotid calcifications were excluded.

RESULTS

Twenty articles met the inclusion criterions. Tumoral and non-tumoral local causes and systemic causes of parotid calcification were found. The way they revealed was variable. The main tumoral local causes were pleomorphic adenomas, salivary duct carcinomas and adenocarcinomas. The main non-tumoral local causes included vascular malformations and calcified parotid lymph nodes. The main systemic causes were chronic kidney diseases, HIV infection, chronic alcoholism, elevated levels of alkaline phosphatase and auto-immune diseases.

DISCUSSION

Eighteen different etiologies of parotid space calcifications could be identified. First line exploration of these lesions relies mainly on conventional radiography and ultrasound examination that are easily available. CT scan remains the reference examination.

Primary sarcomas of the salivary glands: case series and literature review

BACKGROUND

Mesenchymal malignancies of salivary origin are rare and are histologically diverse. We reviewed our experience with these tumors, as well as the published literature, with an emphasis on treatment modalities and prognosis.

METHODS

We identified 17 patients treated for malignant mesenchymal cell tumors at The University of Texas MD Anderson Cancer Center between 1990 and 2007. We compared our results to the literature from January 1990 to July 2010.

RESULTS

Tumors were located primarily in the parotid gland and were primarily T1 tumors (<5 cm). All patients were treated with surgical resection, and 13 patients were given adjuvant therapy. Seven patients (41%) had recurrence, and 4 developed distant metastases. The overall 5-year and 10-year survival rates were 42% and 20%, respectively.

CONCLUSIONS

Our case series and literature review show that sarcomas of the salivary glands have a high rate of recurrence and are associated with a poor prognosis.

Chondrosarcoma of the tongue: a case report and a review of the literature

Chondrosarcoma of the head and neck is uncommon and reported to constitute between 1% to 12% of all chondrosarcoma cases.1, 2, 3 Extraskeletal chondrosarcoma of the tongue is an extremely rare type of neoplasm with only three previously reported cases. The underlying origin of chondrosarcoma arising in the tongue is controversial. We describe a case of a low-grade chondrosarcoma arising in the base of the tongue of a 54-year-old woman with a central area of dedifferentiation. The patient was treated with complete surgical resection with no evidence of recurrence at 1 year follow-up.