Neoplasms of the supporting tissues in the head and neck are outnumbered by their histologic counterparts in the trunk and extremities. This is especially true for tumors of bone, cartilage, and the remnants of the notochord. Malignancies occurring in all three tissues, however, are just as lethal as those sited elsewhere. Chondrosarcomas and osteogenic sarcomas of the facial bones are resistant to all conventional modes of therapy, manifest many recurrences, and have an often protracted morbidity. The craniocervical chordoma manifests a similar biologic course. For the tumors of cartilaginous origin and the osteogenic sarcomas, the initial surgical attempt at removal is of key importance. Neoplasms present at the margins of resection have a poor prognosis. Chordomas are not likely to be cured by any modality.
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