Chondrosarcoma of H&N
H. Ric Harnsberger, MD
Key Facts
Terminology
Definition: Malignant tumor of H&N characterized by formation of cartilaginous matrix
Imaging
CSa locations & frequency
Larynx ≈ skull base (petrooccipital fissure) > mandible (including TMJ, masticator space) > maxilla ≈ nasal septum
Bone CT: Characteristic chondroid calcification in tumor matrix
˜ 50% have matrix calcification
Chondroid calcifications described as “ring & arc” and “popcorn”
MR findings: T2 high signal, especially when calcifications not present
If extensive calcifications, hypointensity may dominate T2 signal
Top Differential Diagnoses
Osteosarcoma of H&N
Metastasis of H&N
Non-Hodgkin lymphoma of H&N
Pathology
Classification based on histology
Hyaline (5%), myxoid (30%), or mixed (63%)
Clinical Issues
Mean age at presentation ˜ 55 years old
Treatment: Surgical resection + radiation therapy
Disease-specific 10-year survival rates of > 90%
Diagnostic Checklist
Consider CSa as diagnosis when expansile or destructive mass of laryngeal cartilage, skull base petrooccipital fissure, mandible, maxilla, or nasal septum shows chondroid calcification
TERMINOLOGY
Abbreviations
Chondrosarcoma of head & neck (CSa H&N)
Definitions
Malignant tumor arising from H&N cartilage or bone characterized by formation of cartilaginous matrix by neoplastic cells
IMAGING
General Features
Best diagnostic clue
H&N tumor demonstrating chondroid tumor matrix leads directly to radiologic diagnosis of CSa
Location
Multiple H&N locations
Difficult to determine relative frequencies
Larynx ≈ skull base (petrooccipital fissure) > mandible (including temporomandibular joint [TMJ], masticator space) > maxilla ≈ nasal septum
Laryngeal CSa: 72% cricoid, 20% thyroid, 8% arytenoid cartilage, hyoid bone
Size
Variable, usually > 3 cm
Morphology
Well-circumscribed, lobulated margins
CT Findings
CECT
Variable, heterogeneous enhancement
Soft tissue extension is late finding
Bone CT
Characteristic chondroid calcification in tumor matrix
˜ 50% have matrix calcification
Descriptive terms for chondroid calcifications include “ring & arc” & “popcorn” calcifications
Cartilage or bone involvement by CSa variable
Expansion of cartilage or bone present
Tumor margin variable from abrupt, benign appearance to destructive margins with local invasion
˜ 50% show cartilage or bone destruction
MR Findings
T1WI
Low to intermediate signal intensity relativeStay updated, free articles. Join our Telegram channel
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