Markovic Vasiljkovic Biljana, Janovic Aleksa, Antic Svetlana, Dozic Branko, Bracanovic Milos, Bracanovic Djurdja
Department of Radiology, School of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Department of Pathology, School of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Diagnostics (Basel). 2024 Feb 6;14(4):348. doi: 10.3390/diagnostics14040348.
Chondrosarcoma (CS) initially suspected to be a periodontal lesion is atypical and rare. To the best of our knowledge, only six similar cases have been reported so far. A 47-year-old woman presented with a discreet swelling of the alveolar process of the mandible, while adjacent mucosa appeared normal. Upon initial intraoral radiography, a periodontal lesion was suspected by the ordinating dentist. Further radiological evaluations included CBCT, CT, and MRI, which showed a thickening of the supporting bone with ground-glass foci but without visible calcifications. The periodontal space of the affected teeth appeared to be uniformly widened. The destruction of the vestibular and lingual cortex was observed, as well as a discreet periosteal reaction, implying the secondary involvement of these teeth and not the odontogenic nature of the lesion. The lesion was restricted to the alveolar process of the mandible, and the bone marrow was not affected. Upon biopsy, a preliminary histopathology report suggested chondrosarcoma, and the patient underwent surgery. It is important to emphasize the possible malignant nature of atypical lesions in the alveolar bone, especially in cases with the expansion of vestibular and lingual cortical plates. Additionally, postoperative "watch and see" follow-ups may be considered in cases of CS in the jaws.
最初被怀疑为牙周病变的软骨肉瘤（CS）并不典型且罕见。据我们所知，迄今为止仅报道了6例类似病例。一名47岁女性下颌牙槽突出现轻微肿胀，而相邻黏膜外观正常。在最初的口腔内放射检查中，主治牙医怀疑是牙周病变。进一步的影像学评估包括锥形束计算机断层扫描（CBCT）、计算机断层扫描（CT）和磁共振成像（MRI），这些检查显示支持骨增厚，有磨玻璃样病灶，但无可见钙化。患牙的牙周间隙似乎均匀增宽。观察到前庭和舌侧皮质的破坏，以及轻微的骨膜反应，这意味着这些牙齿是继发性受累，而非病变的牙源性本质。病变局限于下颌牙槽突，骨髓未受影响。活检时，初步组织病理学报告提示为软骨肉瘤，患者接受了手术。必须强调牙槽骨非典型病变可能具有的恶性性质，尤其是在前庭和舌侧皮质板扩展的病例中。此外，对于颌骨软骨肉瘤病例，术后可考虑进行“观察等待”随访。
