Article

Advanced osteosarcoma of the maxilla: a case report.

Oral and Maxillofacial Surgery, Baleia Hospital, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil.
Medicina oral, patologia oral y cirugia bucal (Impact Factor: 1.1). 09/2008; 13(8):E492-5.
Source: PubMed

ABSTRACT Osteosarcomas are primary malignant bone tumours in which mesenchymal cells produce osteoid. It is generally the most common malignant bone neoplasm, although lesions of the jaw are uncommon. Osteosarcoma of the jaw (JOS) presents a lower incidence of metastasis and a better prognosis than osteosarcoma of the long bones. However, patients with JOS can exhibit advanced tumours, mainly when early diagnosis is not performed. This article reports on a case of an advanced osteosarcoma of the maxilla. A 38-year-old woman was referred for evaluation and treatment of recurrent fibrous dysplasia of the facial bones. The patient related that she had been diagnosed with fibrous dysplasia four years earlier and, since the first diagnosis, she was submitted to four surgical interventions, all followed by recurrences. The main clinical findings were redness and swelling of the facial skin, upper lip ulceration, and hard palate swelling. Computed tomography showed a large hyperdense mass in right maxilla extending to right orbit and left maxillary sinus. An incisional biopsy was performed and microscopic examination showed areas of osteoid and chondroid formation surrounded by a cellular stroma. The diagnosis of osteosarcoma was established and the patient was recommended for oncologic treatment. Unfortunately, she died six months after the diagnosis due to uncontrollable local spread.

Full-text

Available from: Martinho Campolina Rebello Horta, May 28, 2015
3 Followers
 · 
269 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Osteosarcoma is a rare malignant tumor of the maxilla. Although clear surgical margin is the only predictor for the prognosis of the disease, neoadjuvent chemotherapy showed a reasonable effect on the tumor with variable degree of necrosis. In this article, we report two cases where neoadjuvent chemotherapy was used with review of the literature.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Most malignant tumors arise from the primary tissue except when showing extreme dedifferentiation. This can be identified by examination of tumor cells and their products. Occasionally two distinct tissues are recognized within a malignant tumor. In mixed malignant tumors both carcinomatous and sarcomatous elements are present either because of simultaneous malignant change occurring in the epithelium and its nonepithelial stroma or there is a sarcomatous transformation of stroma of a carcinoma. Willey’s in 1960 stated that in these circumstances the resulting tumor must be classified as a “carcino-sarcoma”. These separate tumors arise in nearby structures and may grow to infiltrate in each other resulting in a tumor mass. The present article is a report of a diagnostic dilemma in an extremely rare carcinosarcoma of maxilla in a 24 year old male which was first on biopsy reported as odontogenic myxoma. After resection (right maxillectomy under GA using Weber Fergusons approach with Diffenbach’s extension) was diagnosed as Squamous Cell Carcinoma arising from lining of the maxillary antrum associated with Osteogenic Sarcoma (chondroblastic differentiation) of maxilla with negative margins. The tumor was restaged to T2NoMx and further managed as per National Comprehensive Cancer Network Guidelines. Immunohistochemistry later re-diagnosed it to be an Osteogenic Sarcoma maxilla with chondroblastic differentiation. ‘T’ stage remains the most reliable predictor of survival and loco-regional control. Complete surgical resection for all ‘T’ stages (except T4b, any N) followed by postoperative therapy remains a corner stone of treatment of maxillary sinus tumors.
    Journal of Maxillofacial and Oral Surgery 03/2014; 14(Suppl 1). DOI:10.1007/s12663-013-0603-7
  • Source