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Osteosarcomas (OS) are extremely uncommon in maxillofacial region (6%-10% of all sarcomas). Jaw lesions are diagnosed on average two decades later than sarcomas of long bone, with a peak incidence between 20 and 40 years. Head and neck OS (HNOS) are associated with a lower metastatic rate than long bone OS, and they have a better 5-year survival ra...
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In adult life, proper bone metabolism requires efficient regulation of bone formation and resorption processes. Bone turnover markers allow for assessing the rate of bone formation and resorption processes. In menopausal period, female patients experience gradual reduction in blood estradiol levels. The deficit of estrogens leads to enhanced osteoc...
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... SD = 4.78), the difference in the cellular uptake compared to [ 18 F]AlF-NOTA-pamidronic acid (M = 9.28%, SD = 6.25) was not significant when further statistically analysed using a one-way ANOVA (p > 0.05) (Figure 16). [3,60,61]. Chondroblasts contribute to the formation of cartilage, while fibroblasts form connective tissues that support and connect other tissues or organs in the body [60]. Since the osteoblastic, chondroblastic, and fibroblastic subtypes are predominantly expressed in osteosarcomas, it is possible that the compound investigated in this study, [ 18 F]AlF-NOTA-pamidronic acid, could provide additional information that [ 18 F]NaF could not. ...
... [3,60,61]. Chondroblasts contribute to the formation of cartilage, while fibroblasts form connective tissues that support and connect other tissues or organs in the body [60]. Since the osteoblastic, chondroblastic, and fibroblastic subtypes are predominantly expressed in osteosarcomas, it is possible that the compound investigated in this study, [ 18 F]AlF-NOTA-pamidronic acid, could provide additional information that [ 18 F]NaF could not. ...
[18F]sodium fluoride ([18F]NaF) is recognised to be superior to [99mTc]-methyl diphosphate ([99mTc]Tc-MDP) and 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) in bone imaging. However, there is concern that [18F]NaF uptake is not cancer-specific, leading to a higher number of false-positive interpretations. Therefore, in this work, [18F]AlF-NOTA-pamidronic acid was prepared, optimised, and tested for its in vitro uptake. NOTA-pamidronic acid was prepared by an N-Hydroxysuccinimide (NHS) ester strategy and validated by liquid chromatography-mass spectrometry analysis (LC-MS/MS). Radiolabeling of [18F]AlF-NOTA-pamidronic acid was optimised, and it was ensured that all quality control analysis requirements for the radiopharmaceuticals were met prior to the in vitro cell uptake studies. NOTA-pamidronic acid was successfully prepared and radiolabeled with 18F. The radiolabel was prepared in a 1:1 molar ratio of aluminium chloride (AlCl3) to NOTA-pamidronic acid and heated at 100 °C for 15 min in the presence of 50% ethanol (v/v), which proved to be optimal. The preliminary in vitro results of the binding of the hydroxyapatite showed that [18F]AlF-NOTA-pamidronic acid was as sensitive as [18F]sodium fluoride ([18F]NaF). Normal human osteoblast cell lines (hFOB 1.19) and human osteosarcoma cell lines (Saos-2) were used for the in vitro cellular uptake studies. It was found that [18F]NaF was higher in both cell lines, but [18F]AlF-NOTA-pamidronic acid showed promising cellular uptake in Saos-2. The preliminary results suggest that further preclinical studies of [18F]AlF-NOTA-pamidronic acid are needed before it is transferred to clinical research.
... OS makes up approximately 20% of all sarcomas and is the most common non-haematopoietic primary bone neoplasm, with a reported incidence of around 1 in 100,000 [2]. Involvement of the craniofacial skeleton remains relatively rare, with an estimated incidence of less than 1 per million and is found only in 6-10% of all OS cases [3]. Long bone OS and craniofacial OS share microscopic features; however, they are considered as separate entities [4]. ...
We report a rare case of a 23-year-old male who presented with a four-week history of unilateral recurrent epistaxis and nasal obstruction. This was subsequently diagnosed as high-grade chondroblastic osteosarcoma of the maxillary antrum. Neo-adjuvant chemotherapy was commenced following a multidisciplinary team discussion. The disease progressed through first-line treatment. A radical surgical resection was not possible, and a palliative debulking procedure was performed. The literature comprehensively points towards an early surgical resection with suitable margins at the earliest possible stage. This case highlights that osteosarcoma of the maxilla can be challenging to diagnose and manage. Thus, a high index of suspicion and an early referral to a head and neck specialist is imperative to improve the long-term prognosis in such patients.
... Adjacent soft tissue extension is frequent. [9] At histologic examination, osteosarcomas can be subgrouped into osteoblastic and fibroblastic types, depending on the predominant component. [10] The osteosarcomas are classified as fibroblastic variant when tumor cells are spindleshaped and arranged in interlacing fascicles. ...
... The degree of vascularization varies considerably from scant to abundant. [9] Unlike primary, cardiac, fibroblastic osteosarcoma, myxoma is largely made up of amorphous, mucopolysaccharide-rich matrix conferring the typically "myxoid" aspect whereas fibrosarcoma is composed of mono-morphic spindle cells, with variable mitotic activity arranged in fascicles. ...
Rationale:
Primary cardiac osteosarcoma is a rare tumor. To our knowledge, only 15 cases have been reported in the literature in the past 10 years. We describe a case of primary, cardiac, fibroblastic osteosarcoma in a 42-year-old woman.
Patient concerns:
A 42-year-old woman with a 10-day history of chest pain. Intraoperatively, a mass was found originating from the ostium of the left inferior pulmonary vein in the left atrium, extending to the mitral orifice. Histologically, the tumor contained variable amounts of spindle cells and osseous differentiation in different areas. Primary, cardiac fibroblastic osteosarcoma had the typical appearance of interlacing hyperchromatic spindle-shaped stromal cells associated with osseous matrix.
Diagnoses:
According to the clinicopathological features, diagnosis of primary, cardiac fibroblastic osteosarcoma was made.
Interventions:
Wide surgical excision of the mass was performed.
Outcomes:
Three months after the operation, transthoracic echocardiography demonstrated a 3.2 cm × 2 cm recurrent mass in the wall of the left atrium (LA). She died shortly afterwards as a result of the local disease recurrence.
Lessons:
In this report, we describe a rare case of primary, cardiac fibroblastic osteosarcoma, and findings are helpful for the pathologists would like to further identify the clinicopathological features of this rare tumor.
... Traditional extra-oral techniques, such as the Weber-Ferguson approach provide suitable surgical exposition, nevertheless, they possess the disadvantage of causing external scarring. 14,15 When treating benign conditions, it is suggested to perform intra-oral approaches so as to avoid esthetic facial complications. ...
Pleomorphic adenoma is considered the most frequent benign tumor found in the salivary glands. Histologically it is characterized by presenting epithelial as well as mesenchymal elements. The present study targets the report of a clinical case of a large size pleomorphic adenoma found in a 45 year old patient. The patient was treated at the Oral and Maxillofacial Surgery Unit of the Eastern General Hospital «Dr. Domingo Luciani». The patient reported onset of the disease approximately 17 years before, with a progressive volume increase in the palate. A surgical Brown type II B maxillectomy was planned, with placement of a shutter plate. At a 10 month post-surgery control, tissue formation was observed in the region of the surgical bed, this formation exhibited similar appearance to the surrounding mucosa, with no signs of recurrence and presence of an oral-nasal fistula measuring approximately 2 cm in diameter. Presently, the patient is programmed to receive a fistula closure procedure by means of local flaps as well as subsequent prosthetic rehabilitation.
... 3 The most common osteosarcoma subtypes are osteoblastic osteosarcoma, chondroblastic osteosarcoma, and fibroblastic sarcoma. 4,5 Osteosarcoma occurs predominantly in adolescents and young adults and accounts for~5% of childhood cancers. Most osteosarcoma patients are diagnosed under the age of 25 years, and the disease occurs more often in males than in females. ...
Long noncoding RNAs (lncRNAs) are a class of non-protein-coding molecules longer than 200 nucleotides that are involved in the development and progression of many types of tumors. Numerous lncRNAs regulate cell proliferation, metastasis, and chemotherapeutic drug resistance. Osteosarcoma is one of the main bone tumor subtypes that poses a serious threat to adolescent health. We summarized how lncRNAs regulate osteosarcoma progression, invasion, and drug resistance, as well as how lncRNAs can function as biomarkers or independent prognostic indicators with respect to osteosarcoma therapy.
... Only the histopathological pattern of tumour matrix can provide a useful clue for differentiating chondroblastic OS and CS. The coexistence of bone-forming matrix and a predominating cartilage-forming tumour matrix indicates the presence of chondroblastic OS [23][24][25]. High-grade CSs cannot be distinguished, either cytomorphologically or histologically, from chondroblastic OS in which tumor osteoid is absent, but can be identified by the absence or sparsity of alkaline phosphatase [24,25]. ...
A 6-year-old Rhodesian Ridgeback was presented with a 1.5 year history of right forelimb lameness. Clinical, radiological and computed tomographic findings suggested the presence of fragmented medial coronoid process. A subtotal coronoidectomy was performed and, due to the atypical appearance of the medial coronoid process on imaging and at surgery, histopathology of the fragments was performed which revealed chondroblastic OS. Ten months after surgery, the dog was re-presented with the same clinical signs and the radiographic changes were suggestive of a recurrence of the OS. Palliative therapy was instigated at the owner's request. Thirty months after surgery of the neoplasm, the dog was presented with dyspnea. Thoracic radiographs showed lesions consistent with lung metastases. Euthanasia was requested by the owner, who declined post-mortem examination.
... Histologically, although the current case shares certain features of F-OS like spindle shaped cells and long fascicular pattern and presence of osseous matrix, the lack of cellular atypia clearly excludes this diagnosis [18]. The frequency of occurrence of OS in head and neck bones is only 20% of which the fibroblastic variant accounts for about 3.4% [19] and thus rare in jaw bones. ...
Osteosarcoma is a rare malignant bone tumour characterized by bone or osteoid formation within. Low-grade osteosarcoma (LGOS) represents less than 1% of all osteosarcomas in the body. Because of its rarity and well differentiation, LGOS is usually misdiagnosed as a benign lesion. A 21-year-old male patient presented with a history of slowly expanding hard, painless mass in the left maxilla since six months, along with difficulty in breathing and numbness over left side of the nose since last two months. The radiological and histologic findings summatively suggested a spindle cell tumour with a wide range of differential diagnoses. This manuscript presents a critical evaluation of the clinical, radiographic, histologic and immunohistochemical findings of the case with a detailed discussion of all the probable differential diagnoses.
... Osteosarkomy oblasti hlavy a krku vykazují odlišnosti oproti osteosarkomům dlouhých kostí. Vrchol jejich výskytu je posunut v průměru o deset let později [9], vykazují nižší tendenci k metastatickému rozsevu a mají v průměru vyšší počet pacientů přežívajících pět let [1,7,9,10]. V tomto článku bude popsán případ 32leté pacientky s chondroblastickým osteosarkomem maxily. ...
... Většina osteosarkomů vzniká de novo; za predisponující faktor vzniku je považována fibrózní dysplazie, Pagetova choroba, chronická osteomyelitida, trauma, expozice ionizujícímu záření a některé genetické syndromy (např. Li Fraumeniho syndrom) [7,9]. Histologicky lze rozlišit chondroblastickou, osteoblastickou, fibroblastickou a smíšenou formu v závislosti na přítomnosti a převaze neoplastické složky. ...
... Popisována je mírná predominance výskytu u mužského pohlaví (asi 2 : 1) [6,20]. V době zjištěné diagnózy jde většinou o lokalizované onemocnění (častěji v oblasti mandibuly než maxily), lokoregionální metastázy jsou přítomny asi v 10-15 %, vzdálené jsou méně časté a postihují zejména plíce, játra a kosti [7]. ...
Osteosarcoma (OS) of jaws is a rare entity characterized by malignant osteoid formation and is most commonly seen in third to fourth decade of life. Here, we present a rare and intriguing case of a 14-year-old pediatric patient, who reported with a chief complaint of swelling in the left maxilla, which was rapidly increasing in size. Both cytokeratin AE1/3 and vimentin-positive spindled cells were seen arranged in storiform pattern with minimal areas of osteoid formation on histopathologic examination. The diagnosis of fibroblastic OS was confirmed by fluorescent in situ hybridization after excluding monomorphic synovial sarcoma. The patient underwent segmental resection of left maxilla and is on close follow-up. A PubMed search revealed that only 5 pediatric cases of fibroblastic OS have been published since 1991. Here, we highlight the diagnostic challenges encountered in reaching the histopathologic diagnosis.
