J Korean Soc Radiol.  2015 May;72(5):324-328. 10.3348/jksr.2015.72.5.324.

Extraskeletal Mesenchymal Chondrosarcoma of the Carotid Space: A Case Report

• Huh S
• Hong HS
• Kwak JJ
• Park J
• Jeong SH

• KMID: 1793888
• DOI: http://doi.org/10.3348/jksr.2015.72.5.324

Abstract

Chondrosarcoma is a commonly encountered malignant cartilaginous tumor. However, only 1% of chondrosarcomas arise in the extraskeletal region. The pathologic types of this tumor include mesenchymal, myxoid, and low grade. A mesenchymal chondrosarcoma is a rare, highly malignant cartilaginous tumor that is rarely encountered, and it shows similar imaging features to other malignant soft-tissue tumors. Here, we report a mesenchymal chondrosarcoma presenting as a palpable mass in the neck, arising in the carotid space, which is also known as the retrostyloid parapharyngeal space.

MeSH Terms

Chondrosarcoma
Chondrosarcoma, Mesenchymal*
Neck

Figure

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  Fig. 1 A 64-year-old man presented with a gradually increasing, palpable neck mass and 11 kg weight loss in 9 months. A. Precontrast CT reveals soft tissue density mass in the left carotid space. Dense calcifications with a ring-and-arc pattern representing chondroid calcifications is noted within the mass. B. Contrast enhanced CT reveals heterogeneous enhancing solid mass encasing the left common, internal, and external carotid arteries with splaying internal and external carotid arteries.

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  Fig. 2 The MR images of 64-year-old man with extraskeletal mesenchymal chondrosarcoma of the carotid space. A. The lesion shows heterogeneously hyperintense with heterogeneously low-signal foci representing a chondroid matrix on T2-weighted imaging and reveals invasion of surrounding structures with extension to the lowest crotch of the carotid bifurcation and encasement of the left external and internal carotid arteries. B. Contrast enhanced axial MRI scan shows well enhancing heterogeneous mass with low signal intensity foci in the left carotid space with splaying internal carotid artery and external carotid artery. The lesion shows isosignal intensity on T1-weighted imaging with low-signal-intensity foci (not shown). C. On diffusion-weighted imaging, this mass shows heterogeneous high-signal intensity and diffusion restriction on apparent diffusion coefficient mapping (not shown), suggestive of a malignant character of the tumor.

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  Fig. 3 Histopathological findings have a characteristic bimophic structure. A. One core reveals sheets of hypercellular, undifferentiated tumor cells. The other core shows a well-defined nodule of well-differentiated cartilage. A undifferentiated tumor cells have ovoid or elongated hyperchromatic nuclei and scanty, poorly outlined cytoplasm (hematoxylin-eosin, × 200). B. Chondroid component show well differentiated cartilage (hematoxylin-eosin, × 100).

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