Mandibular Chondrosarcoma Mimicking an Odontogenic Infection: A Case Report.

Chondrosarcoma is a malignant mesenchymal tumor exhibiting cartilaginous differentiation. It is a relatively common primary malignant bone tumor, but its occurrence in the jaws is rare, particularly in the mandible. The clinical presentation may be nonspecific and may mimic odontogenic or inflammatory conditions, potentially resulting in delayed diagnosis. We report the case of a 37-year-old woman with mandibular chondrosarcoma initially presenting with persistent pain in the region of the right mandibular first molar. The lesion was initially managed as a dental condition, and endodontic treatment was performed. Despite treatment, the patient developed persistent symptoms, recurrent right buccal cellulitis, progressive mandibular enlargement, and eventually visible facial asymmetry. Imaging demonstrated an approximately 40 mm intramandibular lesion with irregular borders and cortical expansion. Because of repeated loss to follow-up and limited compliance, no preoperative biopsy was performed before the initial surgical procedure. Intraoperative examination revealed a solid tissue-like lesion rather than a conventional odontogenic cyst. Histopathological examination demonstrated an infiltrative neoplasm with cartilaginous differentiation suspicious for chondrosarcoma. Although the definitive resection specimen raised a differential diagnosis of low-grade parosteal osteosarcoma, expert sarcoma review ultimately retained the diagnosis of mandibular chondrosarcoma. Staging investigations revealed no regional nodal or distant metastatic disease, and the tumor was classified as T4N0M0. The patient subsequently underwent interruptive mandibulectomy with tracheostomy and reconstruction using a vascularized free fibula flap. This case highlights the diagnostic challenges associated with rare mandibular malignancies presenting with apparently odontogenic symptoms and recurrent infection.