Indian Journal of Plastic Surgery
An open access publication of Association of Plastic Surgeons of India
Users Online: 862  
Home | Subscribe | Feedback | Login 
  Navigate here 
  Search
 
  
 Resource links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Article in PDF (1,072 KB)
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
* Registration required (free)  
  In this article
 »  Abstract
 » Introduction
 » Case Report
 » Discussion
 »  References
 »  Article Figures

 Article Access Statistics
    Viewed1769    
    Printed50    
    Emailed0    
    PDF Downloaded63    
    Comments [Add]    
    Cited by others 2    

Recommend this journal

 


 
 Table of Contents    
CASE REPORT
Year : 2012  |  Volume : 45  |  Issue : 3  |  Page : 550-552
 

Soft tissue chondroma of hard palate associated with cleft palate


Vedant (Nehete) Hospital, Nashik, Maharashtra, India

Date of Web Publication12-Jan-2013

Correspondence Address:
Rajendra Nehete
Consultant, Department of Plastic Surgery, Nehete Hospital, Shreehari Kute Marg, Near Mumbai Naka, Nashik - 422 002, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-0358.105974

Rights and Permissions

 » Abstract 

Soft tissue chondroma of palate is very rare. It has never been reported in a cleft palate patient. We report a case of 22-year-old male who came with asymptomatic swelling on the palate since birth, along with complete cleft of secondary palate. He had symptoms related to cleft palate only, i.e., nasal regurgitation and speech abnormalities. Swelling was excised and the cleft palate was repaired. Histopathological examination revealed chondroma of the palate. The patient had no recurrence after 2 years of follow-up.


Keywords: Cleft palate; soft tissue chondroma, benign palatal tumour, palatal swellings


How to cite this article:
Nehete R, Nehete A, Singla S, Sankalecha S. Soft tissue chondroma of hard palate associated with cleft palate. Indian J Plast Surg 2012;45:550-2

How to cite this URL:
Nehete R, Nehete A, Singla S, Sankalecha S. Soft tissue chondroma of hard palate associated with cleft palate. Indian J Plast Surg [serial online] 2012 [cited 2019 Aug 19];45:550-2. Available from: http://www.ijps.org/text.asp?2012/45/3/550/105974



 » Introduction Top


Extraskeletal soft tissue chondroma is a very rare, slow-progressing, benign tumour. It has a specific tendency for the hands and feet. [1] Chondromas are tumour-like masses formed by proliferation of chondrocytes in a mature hyaline matrix. [1],[2] These tumours are very rare in the oral cavity. The tongue is the most common site. [3] In our case, chondroma was associated with cleft palate, which has never been reported before.


 » Case Report Top


A 22-year-male came with chief complaints of asymptomatic swelling on the palate since birth. He had symptoms of cleft palate, i.e., nasal regurgitation and poor speech. On examination, there was a complete cleft of secondary palate and the cleft was filled by non-tender, globular swelling of size 3 sq. cm. There was a linear band of soft tissue extending from the anterior part of the swelling to the upper lip mucosal surface after passing through the diastasis of the upper central incisors [Figure 1].
Figure 1: Pre-operative photograph showing palatal swelling completely obliterating the cleft with linear band extending to the lip

Click here to view


On computed tomography scan, a 30 mm × 28 mm size, well-defined, globular soft tissue mass was seen in the region of the hard palate, which showed fusion defect anteriorly. It had central dense areas of calcification in the mass [Figure 2].
Figure 2: Plain computed tomography coronal section of the swelling

Click here to view


Differential diagnosis of dermoid cyst and chondroma were kept.

Intraoperatively, the tumour was seen attached by a small pedicle to the nasal mucosa of the cleft margin on the right side. The tumour was excised along with the linear band of tissue extending to the mucosal surface of the upper lip [Figure 3]. Cleft palate repair was performed by pushback palatoplasty.

Histopathological examination revealed hypercellular lobules of cartilage composed of evenly spaced chondrocytes of uniform size and separated by collagen and adipose tissue. No evidence of any atypia or mitosis was noted [Figure 4]. There was no recurrence after 2 years of follow-up [Figure 5].
Figure 3: Resected specimen

Click here to view
Figure 4: Histopathological appearance of the chondroma

Click here to view
Figure 5: Two-year follow-up photograph showing repaired palate having adequate length with no recurrence

Click here to view



 » Discussion Top


Soft tissue chondromas are benign cartilage-forming tumours that are usually found in close proximity to the tendon or joint capsules. The hand and foot are the predominant sites. They consist entirely of mature hyaline cartilage. [1],[2] These are very rare in the oral cavity. Only five cases of soft tissue chondroma of palate have been reported in the literature. [3],[4],[5],[6] It has never been reported in a patient of cleft palate.

The aetiology of soft tissue chondroma is uncertain. One theory is that these lesions are from residual embryonal tissue (embryonic remnant theory). The other theory is that these lesions are from metaplasia of pluripotential mesenchymal cells (metaplastic theory). [3] In our case, because the swelling was present since birth, this goes in favour of embryonic remnant theory. Even after a meticulous review of the literature, we could not establish the cause and effect relationship between chondroma and cleft palate. In fact, we feel that the embryonic changes in the palate during the process of cleft might lead to entrapment of mesodermal tissue (mesoderm giving rise to cartilage/bone). The presence of cleft with chondroma has value in embryonic mapping of the palate.

Clinically, these tumors present as slow-growing, firm masses not attached to the underlying bone and are, occasionally, painful. Radiologically, soft tissue chondroma show well-demarcated, extraskeletal, soft tissue masses. Radiographic evidence of calcification has been reported in 30-70% of the cases. [7],[8]

Surgical excision is the treatment of choice. No recurrence has been reported in previous cases. [3],[4],[5],[6]

 
 » References Top

1.Dahlin DC, Salvador AH. Cartilaginous tumors of the soft tissues of the hands and feet. Mayo Clin Proc 1974;49:721-6.  Back to cited text no. 1
[PUBMED]    
2.Krolls SO, Jacoway JR, Alexander WN. Osseous choristomas (Osteomas) of intraoral soft tissues. Oral Surg Oral Med Oral Pathol 1971;32:588-95.  Back to cited text no. 2
[PUBMED]    
3.Kawanoa T, Yanamotoa S, Kawasakia G, Mizunoa A, Fujita S, Ikedab T. Soft tissue chondroma of the hard palate: A case report. Asian J Oral Maxillofac Surg 2011;23:92-5.(Indexed in Embase)  Back to cited text no. 3
    
4.Ramanathan K, Keat TC, Singh H. Chondroma of the palate: Case report. Aust Dent J 1970;15:478-81.  Back to cited text no. 4
[PUBMED]    
5.Snyder SR, Merkow LP. Benign chondroma of the palate: Report of case. J Oral Surg 1973;31:873-5.  Back to cited text no. 5
[PUBMED]    
6.Ide F. Chondromyxoid tumor of palate. J Oral Pathol Med 2006;35:523-4.  Back to cited text no. 6
[PUBMED]    
7.Zlatkin MB, Lander PH, Begin LR, Hadjipavlou A. Soft-tissue chondroma. AJR Am J Roentgenol 1985;144:1263-7.  Back to cited text no. 7
[PUBMED]    
8.Kransdorf MJ, Meis JM. Extraskeletal osseous and cartilaginous tumor of the extremities. Radiographics 1993;13:853-84.  Back to cited text no. 8
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]


This article has been cited by
1 Soft Tissue Chondroma of the Oral Cavity: An Extremely Rare Tumour Localized on the Hard Palate
Paolo Vescovi,Marco Meleti,Elisabetta Merigo,Maddalena Manfredi,Domenico Corradi,Ilaria Giovannacci,Tito Poli,Samir Nammour
Case Reports in Medicine. 2014; 2014: 1
[Pubmed] | [DOI]
2 rare tumours of the hard palate
mohapatra, d.p. and badhe, b.a. and chittoria, r.k. and vijayaraghavan and ashokan, a.
indian journal of plastic surgery. 2013; 46(1): 150-152
[Pubmed]



 

Top
Print this article  Email this article
 

    

Site Map  |  Home  |  Contact Us  |  Feedback  |  Copyright and Disclaimer
Online since 11th March '04
Published by Wolters Kluwer - Medknow