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      Osteosarcoma of mandible: Detailed radiographic assessment of a case

      case-report

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          Abstract

          Osteosarcoma (OS) is a malignant connective tissue tumor originating from bone and is the most common primary bone malignancy of long bones but seldom arises in jaw bones. Osteosarcoma of jaws is frequently seen arising in the second and third decade as compared to earlier occurrences in other bones and show a slight predilection for body of mandible. It is a highly malignant tumor with varied radiographic features. We present a case with detailed radiographic assessment using intraoral radiograph, computed tomography (CT), 3-D CT, CT angiography techniques and histological evaluation.

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          Craniofacial osteosarcoma Experience of the cooperative German-Austrian-Swiss osteosarcoma study group.

          Ulrich Meyer, U. Joos, Stefan S. Bielack … (2008)
          The aim of this retrospective analysis was to evaluate patient and tumor characteristics and treatment results and prognostic factors for patients with craniofacial osteosarcoma (CFOS). The COSS database was searched for patients with previously untreated, histologically confirmed craniofacial osteosarcoma with at least one follow-up examination. In a 28-year period extending from 1977 to 2004, 49 eligible patients were identified and their charts retrospectively analysed. The median age at diagnosis was 19.7 years (range: 4.6-57.2) with no gender predilection. Thirteen CFOS were second or even third primary malignancies. The jaws were the primary site in 27 patients (55% - mandible 15 (31%), maxilla 12 (24%)), while extragnathic bones were involved in 22 (45%). All 49 patients underwent surgery; in 37 (76%) combined with chemotherapy, in seven (14%) with chemotherapy and radiotherapy. Twenty-one patients (43%) received preoperative chemotherapy and the other 28 (57%) had primary surgery. A complete surgical remission was achieved in 32 patients, of whom 24 remained in local control. Actuarial five-year overall and event-free survival rates were 74% and 44%, respectively. Extragnathic site (p<.001) and documented postsurgical rest of the primary tumor (p<.001) were associated with inferior overall survival probabilities. All 24 patients who achieved and maintained local surgical control survived disease-free. Multidisciplinary treatment of CFOS within a multicenter setting resulted in long-term survival in well over two thirds of affected patients. Extragnathic sites and failure to achieve and maintain local surgical control emerged as strong negative prognostic factors.
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            Osteosarcoma of the jaw.

            Vivek K. Unni, C Dahlin, Adrian Clark … (1983)
            The records of 66 patients with osteosarcoma of the jaw were reviewed. The ages of the 42 males and 24 females ranged from 12 to 79 years (mean, 34.2 years). Swelling and pain, the most frequent presenting complaints, were noted an average of three months before the patient was seen by a physician. Fifty-one percent of the lesions involved the maxilla and 49% involved the mandible. The most common sites of involvement were the body of the mandible and the alveolar ridge of the maxilla. Radiologically, most of the lesions in the maxilla were osteoblastic (50%), whereas most of those in the mandible were osteolytic (43%). Chondroblastic osteosarcoma was the most frequent histologic type (48%) and was associated with the best survival rate (47%). Treatment included radical and local surgery with radiotherapy, chemotherapy, or various combinations. The recurrence rate for all treatment modalities was 70%. Patients treated by initial radical surgery had the best survival (80%). Survival decreased to 27% with local surgery. Of the 43 (65%) patients who died, most died with uncontrolled local disease; only four patients had documented distant metastasis, which involved lung, cervical lymph nodes, spinal column, and brain.
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              Osteosarcoma of the jaw. The Chaim Sheba Medical Center experience.

              S Taicher, Y Talmi, O Mardinger … (2001)
              The purpose of this article is to present 14 cases of osteosarcoma of the jaw treated at our medical center from 1989 to 1998. These cases are discussed in the light of a comprehensive review of 774 cases reported in the English literature over the past 3 decades. Differences between osteosarcoma of the jaws and osteosarcoma of the long bones are examined. The patients ranged in age from 8 to 78 years, the mean age being 33 years. Each patient had a histopathologically established diagnosis of osteosarcoma of the jaw. Records were reviewed for epidemiologic data, treatment modalities, and survival. Of the 14 patients, 6 (42%) had tumors in the mandible and 8 (58%) had tumors in the maxilla. Of the mandibular tumors, 5 occurred in the body of the mandible; all maxillary tumors originated in the alveolar ridge and involved the maxillary sinus. The chief complaint was an intraoral or extraoral painless swelling. Histopathologic types included chondroblastic, osteoblastic, fibroblastic, and malignant fibrous histiocytoma-like. Pathologic grade was determined to be high (3 or 4) in 13 cases and low (1) in only 1 mandibular case. All patients underwent surgical resection and immediate reconstruction. Adjuvant therapy included postoperative radiation (5 patients), postoperative chemotherapy (2 patients), and preoperative chemotherapy and postoperative radiation (1 patient). The results of the present study support the literature indicating that osteosarcoma of the jaw differs from osteosarcoma of the long bones in its biological behavior even though they have the same histologic appearance. Because of differences in tumor characteristics, the introduction of chemotherapy did not dramatically alter the prognosis of osteosarcoma of the jaw. Early diagnosis and radical surgery are the keys to high survival rates.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Contemp Clin Dent
                Journal ID (iso-abbrev): Contemp Clin Dent
                Journal ID (publisher-id): CCD
                Title: Contemporary Clinical Dentistry
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0976-237X
                ISSN (Electronic): 0976-2361
                Publication date (Print): Jul-Sep 2013
                Volume: 4
                Issue: 3
                Pages: 382-385
                Affiliations
                [1] Department of Oral Pathology, Jodhpur Dental College, Jodhpur, Rajasthan, India
                [1 ] Department of Oral and Maxillofacial Pathology, Jaipur Dental College, Jaipur, Rajasthan, India
                [2 ] Department of Oral Pathology, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
                [3 ] Department of Oral Pathology, SGT Dental College and Hospital, Gurgaon, Haryana, India
                Author notes
                Correspondence: Dr. Piyush Arora, Department of Oral Pathology, Jodhpur Dental College, Village, Boranada, Jodhpur, Rajasthan, India. E-mail: docpiyusharora@ 123456gmail.com
                Article
                Publisher ID: CCD-4-382
                DOI: 10.4103/0976-237X.118355
                PMC ID: 3793566
                PubMed ID: 24124311
                SO-VID: 0bbcc3ea-ef6d-4ecc-9a31-05c8b32dd661
                Copyright © Copyright: © Contemporary Clinical Dentistry
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Dentistry
                Keywords: computed tomography,osteosarcoma,osteosarcoma of jaws
                Data availability:
                ScienceOpen disciplines: Dentistry
                Keywords: computed tomography, osteosarcoma, osteosarcoma of jaws

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