Mandibular chondroblastic type osteosarcoma primarily diagnosed as chondrosarcoma as a result of radiation therapy: a case report

Alise Elizabete Rone; Ieva Bāgante; Irina Vasiļčenko; Jānis Zariņš; Renārs Deksnis; Sigita Hasnere

doi:10.18203/issn.2454-2156.IntJSciRep20250351

Authors

Alise Elizabete Rone Department of Oral and Maxillofacial Surgery, Pauls Stradins Clinical University Hospital, Latvia; Department of Oral and Maxillofacial Surgery and Oral Medicine, Riga Stradins University, Latvia
Ieva Bāgante Department of Oral and Maxillofacial Surgery, Pauls Stradins Clinical University Hospital, Latvia; Department of Oral and Maxillofacial Surgery and Oral Medicine, Riga Stradins University, Latvia
Irina Vasiļčenko Department of Oral and Maxillofacial Surgery, Pauls Stradins Clinical University Hospital, Latvia
Jānis Zariņš Department of Hand and Plastic surgery, Microsurgery Centre of Latvia, Riga East University Hospital, Latvia; Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, Latvia
Renārs Deksnis Department of Head and Neck surgery, Oncology Centre of Latvia, Riga East University Hospital, Latvia
Sigita Hasnere Department of Clinic of Oncology, Pauls Stradins Clinical University Hospital, Latvia

DOI:

https://doi.org/10.18203/issn.2454-2156.IntJSciRep20250351

Keywords:

Chondroblastic type osteosarcoma, Lingual carcinoma, Mandibular chondrosarcoma, Radiation therapy

Abstract

Radiation therapy is a recognized etiological factor for osteomyelitis, osteoradionecrosis and multiple sarcomas such as chondrosarcoma and osteosarcoma. Here we present a case of mandibular chondroblastic type osteosarcoma induced by radiotherapy which was primarily misdiagnosed as chondrosarcoma. A female presented with main complaint of pain at the extraction site following multiple teeth extraction and sequestrectomy on the right lower jaw. Medical history revealed stage IV squamous cell carcinoma of the base of the tongue which was treated by surgical excision, chemotherapy and radiotherapy ten years ago. Four recurring sequestrectomies were performed, but only histological material from the fourth sequestrectomy revealed grade 2 chondrosarcoma. This was followed by resection of the tumour and floor of the mouth, mandibular, lip and facial skin reconstruction and operation material through histology was again confirmed to be grade 2 chondrosarcomas. In a year’s time, pathological nodule in thyroid gland was found on CT, surgery was performed. Operation material now revealed high grade chondroblastic type osteosarcoma and additional radiotherapy and chemotherapy was prescribed. This case illustrated chondrosarcoma and chondroblastic type osteosarcoma as a rare malignant incidence, with diagnostical difficulties and treatment. Differential diagnosis should be considered if no positive changes are observed after the designated therapy as well as importance of immuno histological evaluation. One treated malignancy does not exclude development of another unrelated malignancy.

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