A 52-year-old man presented with a 6-month history of a soft tissue mass around the right axillary region, which appeared to be gradually increasing in size. He had no history of any major illness or trauma. Physical examination showed a nontender mass measuring 3×3 cm with a hard-elastic consistency that was palpable over the right axillary area. The mass was well demarcated from the surrounding structures, and no skin changes or neurovascular deficit were present.\nPlain radiographs showed soft tissue swelling with stippled calcification on the right medial axillary region (). Pathologic findings showed no osteolysis or cortical destruction around the lesion. CT also depicted calcification without an osteolytic lesion, and without thinning or expansion of the cortex of bone around the lesion (). In MR images, the peripheral area exhibited high intensity in both T1-weighted and T2-weighted images, whereas the central area exhibited low intensity in both (). Enhanced MRI revealed peripheral and mild speculated enhancement around the lesion, which was regarded to be due to calcification (). Chest and abdominal CT and a bone scan showed no evidence of metastasis.\nThe mass, lying on the latissimus dorsi muscle was excised. The tumor measured 3×3×3 cm in dimensions and appeared to be well-encapsulated. The longitudinal section of the resected mass revealed tan-white tissue with central and focal areas of hemorrhage and necrosis (). The histologic examination was consistent with a diagnosis of mesenchymal chondrosarcoma. The tumor consisted of undifferentiated small neoplastic cells, varying from round to spindle-shaped, and interspersed with well differentiated foci of cartilaginous tissue ().\nThe patient underwent a course of postoperative external beam radiation (6,000 cGy over 30 treatment sessions). At 1 year after surgery, the patient had remained free of local recurrence or metastasis.
A 56-year-old female was admitted in the Department of Oral Maxillofacial Head and Neck Oncology Surgery with a history of painless mass of the left posterior region of the parotid gland. The swelling was slowly progressive over a period of 2 months and there were no associated systemic symptoms. Physical examination revealed a parotid mass 1.5 cm × 2 cm × 2 cm in size, firm in consistency, and with no palpable cervical lymph nodes. The preoperative computed tomography (CT) scan depicted a 4.5 cm × 3.4 cm × 3.2 cm sized irregular lobular mass involving the deep lobe of the left parotid gland. Margins were clear, uneven texture, and the compression of the left internal jugular vein with the forward displacement was observed. The cervical lymph nodes were not enlarged []. The coronal CT demonstrated a soft tissue mass that extended up to the left temporal bone []. Parotid gland pleomorphism adenoma or facial nerve neurilemmoma was the clinical differential diagnosis. Following discussion and after obtaining consent from the patient, left partial parotidectomy with conservation of facial nerve was performed under general anesthesia. During the course of the surgery, the tumor was identified with an intact capsule and jugular vein, and the carotid artery was palpated [Figure –].