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Head and Neck Low Grade Chondrosarcoma—A Rare Entity

Chondrosarcoma represents approximately 0.1% of all neoplasms of the head and neck and is considered a rare disease with a relatively good prognosis. The 5-year overall survival (OS) rate is estimated at 70–80%, being considered a disease with a low growth rate. Approximately 13% of all cases of cho...

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Autores principales: Mireștean, Camil Ciprian, Simionescu, Cristiana Eugenia, Iancu, Roxana Irina, Stan, Mihai Cosmin, Iancu, Dragoș Petru Teodor, Bădulescu, Florinel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10572587/
https://www.ncbi.nlm.nih.gov/pubmed/37835769
http://dx.doi.org/10.3390/diagnostics13193026
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author Mireștean, Camil Ciprian
Simionescu, Cristiana Eugenia
Iancu, Roxana Irina
Stan, Mihai Cosmin
Iancu, Dragoș Petru Teodor
Bădulescu, Florinel
author_facet Mireștean, Camil Ciprian
Simionescu, Cristiana Eugenia
Iancu, Roxana Irina
Stan, Mihai Cosmin
Iancu, Dragoș Petru Teodor
Bădulescu, Florinel
author_sort Mireștean, Camil Ciprian
collection PubMed
description Chondrosarcoma represents approximately 0.1% of all neoplasms of the head and neck and is considered a rare disease with a relatively good prognosis. The 5-year overall survival (OS) rate is estimated at 70–80%, being considered a disease with a low growth rate. Approximately 13% of all cases of chondrosarcoma are located in the region of the head and neck. We present the case of a 30-year-old patient without a medical history who reported dysphagia, swallowing difficulty, neck mass sensation and dysphonia that started insidiously after an upper respiratory tract infection. Subsequently, the patient was diagnosed with a low-grade glosso-epiglottic region chondrosarcoma and was multimodally treated with surgery followed by chemotherapy and radiotherapy. The radiation treatment was delivered with a Rokus M40 former Soviet Union cobalt machine without any image guidance capabilities. The inability to obtain resection margin information justified an aggressive adjuvant treatment with chemotherapy and radiotherapy. The early loss from the oncological record without recurrence of the disease could be associated in this case with the consequence of a major complication, of which we could assume an aspiration pneumonia secondary to a dysphagia associated with an aggressive multidisciplinary treatment. Large tumor size and positive resection margins (R1 resection) are risk factors that support an intensive adjuvant approach in order to reduce the risk of recurrence, but the low grade of tumor associated with a lower risk of recurrence as well as the adverse events (AE) of adjuvant radiotherapy and chemotherapy justify a more reserved therapeutic approach. Taking into account the longer life expectancy of these patients, it is recommended to use a more conformal irradiation technique in order to reduce doses to radiosensitive structures as well as to omit elective neck irradiation, taking into account the lower risk of lymph node involvement. The lack of guidelines, which include very rare tumors including low grade chondrosarcoma of the head and neck, makes a unified approach difficult, but the data presented in case reports could contribute to choosing the regimen that offers the best therapeutic ratio.
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spelling pubmed-105725872023-10-14 Head and Neck Low Grade Chondrosarcoma—A Rare Entity Mireștean, Camil Ciprian Simionescu, Cristiana Eugenia Iancu, Roxana Irina Stan, Mihai Cosmin Iancu, Dragoș Petru Teodor Bădulescu, Florinel Diagnostics (Basel) Case Report Chondrosarcoma represents approximately 0.1% of all neoplasms of the head and neck and is considered a rare disease with a relatively good prognosis. The 5-year overall survival (OS) rate is estimated at 70–80%, being considered a disease with a low growth rate. Approximately 13% of all cases of chondrosarcoma are located in the region of the head and neck. We present the case of a 30-year-old patient without a medical history who reported dysphagia, swallowing difficulty, neck mass sensation and dysphonia that started insidiously after an upper respiratory tract infection. Subsequently, the patient was diagnosed with a low-grade glosso-epiglottic region chondrosarcoma and was multimodally treated with surgery followed by chemotherapy and radiotherapy. The radiation treatment was delivered with a Rokus M40 former Soviet Union cobalt machine without any image guidance capabilities. The inability to obtain resection margin information justified an aggressive adjuvant treatment with chemotherapy and radiotherapy. The early loss from the oncological record without recurrence of the disease could be associated in this case with the consequence of a major complication, of which we could assume an aspiration pneumonia secondary to a dysphagia associated with an aggressive multidisciplinary treatment. Large tumor size and positive resection margins (R1 resection) are risk factors that support an intensive adjuvant approach in order to reduce the risk of recurrence, but the low grade of tumor associated with a lower risk of recurrence as well as the adverse events (AE) of adjuvant radiotherapy and chemotherapy justify a more reserved therapeutic approach. Taking into account the longer life expectancy of these patients, it is recommended to use a more conformal irradiation technique in order to reduce doses to radiosensitive structures as well as to omit elective neck irradiation, taking into account the lower risk of lymph node involvement. The lack of guidelines, which include very rare tumors including low grade chondrosarcoma of the head and neck, makes a unified approach difficult, but the data presented in case reports could contribute to choosing the regimen that offers the best therapeutic ratio. MDPI 2023-09-22 /pmc/articles/PMC10572587/ /pubmed/37835769 http://dx.doi.org/10.3390/diagnostics13193026 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Mireștean, Camil Ciprian
Simionescu, Cristiana Eugenia
Iancu, Roxana Irina
Stan, Mihai Cosmin
Iancu, Dragoș Petru Teodor
Bădulescu, Florinel
Head and Neck Low Grade Chondrosarcoma—A Rare Entity
title Head and Neck Low Grade Chondrosarcoma—A Rare Entity
title_full Head and Neck Low Grade Chondrosarcoma—A Rare Entity
title_fullStr Head and Neck Low Grade Chondrosarcoma—A Rare Entity
title_full_unstemmed Head and Neck Low Grade Chondrosarcoma—A Rare Entity
title_short Head and Neck Low Grade Chondrosarcoma—A Rare Entity
title_sort head and neck low grade chondrosarcoma—a rare entity
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10572587/
https://www.ncbi.nlm.nih.gov/pubmed/37835769
http://dx.doi.org/10.3390/diagnostics13193026
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