26629302 Visualization

A 13 Age year Age - old Age boy Sex presented Clinical_event with a 1 Duration month Duration history of intermittent Biological_structure episodes of small Detailed_description volume Detailed_description epistaxis Sign_symptom .
There was no History significant History past History medical, History surgical History or History family History history History .
Physical Diagnostic_procedure examination Diagnostic_procedure revealed a left Biological_structure palatal Biological_structure fleshy Detailed_description mass Sign_symptom centered at left Biological_structure posterior Biological_structure molars Biological_structure .
A nasoendoscopic Diagnostic_procedure examination Diagnostic_procedure demonstrated a large Severity swelling Sign_symptom on the floor Biological_structure of Biological_structure left Biological_structure anterior Biological_structure nasal Biological_structure space Biological_structure , involving the left Biological_structure inferior Biological_structure meatus Biological_structure and abutting the inferior Biological_structure turbinate Biological_structure .
Computed Diagnostic_procedure Tomography Diagnostic_procedure ( CT Diagnostic_procedure ) of the paranasal Biological_structure sinuses Biological_structure showed a lobulated Detailed_description , expansile Detailed_description lytic Detailed_description lesion Sign_symptom of left Biological_structure maxilla Biological_structure [Fig 1] with a lucent Detailed_description center Detailed_description and peripheral Detailed_description calcifications Detailed_description .
The lesion Coreference was associated with a large Detailed_description soft Detailed_description tissue Detailed_description component Detailed_description that demonstrated mild Severity heterogeneous Detailed_description contrast Sign_symptom enhancement Sign_symptom .
The lesion Coreference was centered at the left Biological_structure maxillary Biological_structure alveolus Biological_structure , involving the left Biological_structure hard Biological_structure palate Biological_structure , inferior Biological_structure part Biological_structure of Biological_structure the Biological_structure anterior Biological_structure left Biological_structure maxillary Biological_structure wall Biological_structure and medial Biological_structure left Biological_structure maxillary Biological_structure wall Biological_structure .
The lesion Coreference also involved the roots Biological_structure of Biological_structure the Biological_structure left Biological_structure maxillary Biological_structure molars Biological_structure and Biological_structure pre Biological_structure - molars Biological_structure and was abutting the left Biological_structure orbital Biological_structure floor Biological_structure , with no gross orbital Biological_structure invasion Sign_symptom .
The patient subsequently underwent 18 Diagnostic_procedure - FDG Diagnostic_procedure PET Diagnostic_procedure - CT Diagnostic_procedure study Diagnostic_procedure .
The mass Coreference centered in left Biological_structure maxilla Biological_structure was hypermetabolic Detailed_description , with index Lab_value SUVmax Lab_value 9.7 Lab_value [Fig 2].
There was no FDG Detailed_description - avid Detailed_description metastatic Disease_disorder disease Disease_disorder .
A trans Detailed_description - oral Detailed_description incisional Diagnostic_procedure biopsy Diagnostic_procedure of the left Biological_structure palatal Biological_structure mass Sign_symptom was performed and was suggestive of a preliminary diagnosis of mesenchymal Disease_disorder chondrosarcoma Disease_disorder , as evidenced by a biphasic Detailed_description pattern Detailed_description featuring sheets Detailed_description of Detailed_description small Detailed_description round Detailed_description cells Detailed_description with hemangiopericytoma Detailed_description - like Detailed_description vascular Detailed_description pattern Detailed_description and mature Detailed_description cartilaginous Detailed_description islands Detailed_description .
The patient underwent left Detailed_description subtotal Detailed_description maxillectomy Therapeutic_procedure via lateral Detailed_description rhinotomy Therapeutic_procedure and translabial Detailed_description approach Detailed_description .
The final histology Diagnostic_procedure was conclusive of a 5cm Distance high Lab_value - grade Lab_value ( Grade Lab_value 3 Lab_value ) mesenchymal Disease_disorder chondrosarcoma Disease_disorder .
One of the resection Biological_structure margins Biological_structure was positive for tumor Sign_symptom involvement Sign_symptom and the patient was planned for adjuvant Detailed_description chemotherapy Medication .