Article

Low-grade central osteosarcoma of the mandible: a case study report.

Department of Stomatology, School of Dentistry, Federal University of Goiás, Goiás, Brazil.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics (impact factor: 1.5). 03/2007; 103(2):246-52. DOI:10.1016/j.tripleo.2005.11.006 pp.246-52
Source: PubMed

ABSTRACT Low-grade central osteosarcoma is a rare type of osteosarcoma with peculiar clinical radiographic and microscopic features. The aim of this article is to report and discuss a case of low-grade central osteosarcoma in the mandible of a 42-year-old woman. The patient reported sensing mild pain and tooth mobility for a period of 4 years, despite continuous dental treatment. Radiographic evaluation showed a mixed radiopaque/radiolucenct lesion in the body, ramus, coronoid process, and condyle of the left side of the mandible. Destruction of the mandibular cortex in the area was also observed. After incisional biopsy, the patient underwent hemimandibulectomy. Microscopic findings showed a tumor exhibiting spindle cells with nuclear hyperchromasia and no mitotic activity, irregular osteoid formation, and soft tissue infiltration. The immunohistochemical analysis of the expression of Ki-67, Cyclin B1, and PCNA proteins (cellular proliferation markers) revealed a very low Ki-67+ and Cyclin B1+ cell index (mean 7% and 3%, respectively), but a moderate number of PCNA+ cells (mean 49%). The 2 years of clinical and imaging postoperative follow-up showed no evidence of recurrence. Clinicians should be aware of these lesions, because histopathologicially low-grade central osteosarcoma may be misinterpreted as fibrous dysplasia.

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    Orphanet Journal of Rare Diseases 05/2012; 7 Suppl 1:S2. · 5.83 Impact Factor
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Keywords

42-year-old woman
 
cellular proliferation markers
 
continuous dental treatment
 
Cyclin B1
 
Cyclin B1+ cell index
 
fibrous dysplasia
 
histopathologicially low-grade central osteosarcoma
 
imaging postoperative follow-up
 
immunohistochemical analysis
 
irregular osteoid formation
 
left side
 
low-grade central osteosarcoma
 
mandibular cortex
 
microscopic features
 
PCNA proteins
 
PCNA+ cells
 
peculiar clinical radiographic
 
soft tissue infiltration
 
spindle cells
 
tooth mobility
 

Ana Flávia N M S Diniz