Maxillary chondrosarcoma mimicking torus palatinus.

Brimioulle M, et al. BMJ Case Rep 2017. doi:10.1136/bcr-2017-221629 Description An 88-year-old man was referred to the head and neck surgery clinic for investigation of a painless hard palate lesion. The mass had been present for several months and was identified incidentally by the general practitioner. There were no oral or sinonasal symptoms. On examination, a 3×2 cm hard palatal swelling, covered by normal mucosa and resembling a torus palatinus was identified (figure 1). Flexible nasal endoscopy revealed the tumour to involve the floor of the nasal cavity bilaterally, displacing the inferior nasal turbinates. Examination of the neck was normal. A biopsy was taken, and histological analysis described a welldifferentiated cartilaginous lesion consistent with a grade 1 chondrosarcoma. A CT scan was performed (figure 2). The regional head and neck and regional sarcoma multidisciplinary team meetings recommended surgical management. The patient underwent a partial central maxillectomy via a combined approach (transoral and lateral rhinotomy). The palatal defect was temporarily obturated with a silicon putty, which was replaced by a permanent obturator 9 days later. The patient made a good recovery, and remains well with full speech and swallow 8 months postoperatively. The resemblance of this lesion to a torus palatinus was striking. Similarly to tori, this lesion appeared in adult life and was painless. However, whereas tori