Chondrosarcoma of the Alveolar Process of the Mandible Initially Suspected to Be a Periodontal Lesion

TL;DR

A rare case of chondrosarcoma in the jaw was initially mistaken for a periodontal issue, highlighting the importance of thorough diagnosis.

Contribution

This paper presents a rare case of chondrosarcoma in the mandible misdiagnosed as a periodontal lesion.

Findings

Chondrosarcoma was initially suspected to be a periodontal lesion in a 47-year-old woman.

Radiological evaluations revealed thickening of the supporting bone with ground-glass foci.

Biopsy confirmed chondrosarcoma, and surgery was performed.

Abstract

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.

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