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: 1.02). 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.

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    ABSTRACT: Osteosarcoma is a classical malignant bone-forming neoplasm which usually presents with an aggressive clinical course. The current case is presented with the radiographic feature of widening of the periodontal ligament space of the involved teeth, which is considered to be the earliest radiographic manifestation of osteosarcoma involving the jaw bone. The main aim of this case report was to focus on the importance of early diagnosis of this tumor based on clinical and radiographic examinations, and confirmation by histopathology. Considering the rarity of the disease type and particularly taking into account the fast progression and aggressiveness of this neoplasm, it is clear that the presentation of a clinical case represents a major contribution to better understanding of osteosarcomas involving the jaw bone.
    Imaging science in dentistry. 03/2014; 44(1):85-8.
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    ABSTRACT: BACKGROUND: In the head and neck region, osteosarcoma is the most common primary malignant bone tumor, representing 23% of total head and neck malignancies. Osteosarcomas of the jaws are nevertheless rare lesions, representing only 2 to 10% of all osteosarcomas. This report reviews a single-center histopathology experience with craniofacial osteosarcomas, and reports the management of unusually large synchronous mandibular and maxillary osteosarcomas in a patient.Patients and methodsA search of the hospital pathology database for specimens with a histological diagnosis of osteosarcomas submitted between July 1992 and May 2011 was made. A chart review of a patient with large synchronous maxillary and mandibular osteosarcomas was performed, and is reported. CASE PRESENTATION: A 21-year-old African man with large maxillary and mandibular tumors under palliative care presented with increasing difficulties with eating, speech, and breathing. Surgical debulking was performed, with histology confirming synchronous osteosarcomas of the mandible and maxilla. The patient is well after one year, with no evidence of recurrence, having undergone no further treatment. CONCLUSION: Osteosarcomas of the jaw remain enigmatic, and a number of difficulties related to their diagnosis and treatment are yet to be resolved. True synchronous multicentric osteosarcomas of the jaws are extremely rare but, like other osteosarcomas of the jaws, have a favorable outcome, and palliative resection of such lesions, though challenging, can therefore lead to an enormously improved quality of life and self-image, and may even offer the opportunity for cure.
    World Journal of Surgical Oncology 11/2012; 10(1):240. · 1.09 Impact Factor
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    ABSTRACT: Osteosarcoma is a common primary malignant bone tumor producing osteoid or bone. It occurs very infrequently in the jaws and comprises of 4% of the tumour number as compared to the osteosarcoma of the long bones. Os-teosarcoma of the maxilla is even rarer presenting with common clinical features of pain and swelling. This pre-sented case is a rare case of osteosarcoma of maxilla in a 21-year-old female patient. Diagnosis and pre-operative assessment was performed using a combination of intraoral periapical radiograph, occlusal radiograph, paranasal view and computed tomography (CT). CT revealed destruction of the walls of maxillary sinus and sunray type of ossification in the soft tissues. Conformation was done with histology report followed by surgical removal of the tumor with safety margins. Dental professionals may be the first to detect jaw osteosarcomas in their initial stages. Regardless of the favourable biological behaviour, the patients of jaw osteosarcoma usually exhibit advanced tumor as it often goes unnoticed by the dental professional thus stressing on the need for early diagnosis of the lesion. The aim of this case report is to draw attention to the possibility of diagnosing this tumor based on clinical and radio-graphical characteristics before confirmation by histology.
    Journal of Clinical and Experimental dentistry. 06/2010; J Clin Exp Dent. 2010;2(3):e117-20..

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