Osteosarcoma of mandible initially resembling lesion of dental periapex: a case report

Abstract

Osteosarcoma is a malignant mesenchymal tumor whose cancerous cells produce osteoid matrix. It is the most common primary malignant bone tumor, accounting for approximately 20% of the sarcomas, but only 5% of the osteosarcomas occur in the jaws. They present various clinical and histological aspects, as well as variable disease progression and outcome. This article shows a case report of a 20-year-old woman who presented swelling near the mandibular left premolar. After clinical diagnosis of lesion of the dental periapex, the patient initially underwent endodontic treatment of the tooth involved. Thereafter, in a period of eleven days, a significant increase of the lesion could be observed, resulting in visible facial asymmetry. The occlusal radiographic view showed an area of bone destruction and abnormal bone formation in the region. The external cortical portion showed clear radiopacity resembling sunrays, suggesting the diagnosis of osteosarcoma. The treatment comprised partial mandibulectomy and reconstruction of the area, using bone of the rib and skin graft from the buttock for the oral mucosa involved. Eight months after surgery, there was local recurrence of the lesion and the patient died approximately one year after relapse.

Giant Chondroblastic Osteosarcoma Mandible-A Rare Case Report

“…The clinical manifestation of mandibular osteosarcoma are pain, swelling over bone and adjacent soft tissues, bulging and dislocation of tooth, lack of healing and swelling at the site of tooth extraction, and neurological disorders [3][4][5]. Osteosarcoma of mandible presents various clinical and histological aspects, as well as variable disease progression and outcome.…”

Jaw malignancies: signs that should alert the dentist

“…Dental practionner should search these signs through the interrogation, clinical examination and radiographies. Some preexisting etiologic conditions can lead to the development of malignant tumour, such as underlying bone disorder or previous exposure to cervicofacial radiation [2]; it was the state of our third observation. The delay between radiation therapy and the development of the osteosarcoma was of 15 years.…”

“…In the third observation, after the biopsy, the course of the lesion had rapidly changed, it increased twice in size in few days. The fast growth of the lesion found the three cases, and it was a very important sign in favour of malignancy [2]. Painful swelling and associated toothache without evident dental cause are likely in favour of malignancies, benign lesions are rarely painful [4].…”

Osteosarcoma of mandible: A case report

“…The biological behavior of the osteosarcoma in the long bones differ with the jaws osteosarcoma. There have been few reports of metastasis from jaw Osteosarcoma (1% of all malignancy) to a distant parts of body as compared to osteosarcoma of long bones which makes jaw osteosarcomas prognostically better [7,9]. This case report emphasizes on the fact that asymptomatic lesions may occur in the jaws which can create diagnostic dilemma and delay early diagnosis.…”

“…The maxillary tumours develop from the alveolar ridge, the sinus floor and palate. Pain and swelling are most common sign and symptom associated with looseness of teeth, lack of healing at the extracted site, hypoesthesia or paraesthesia in case of mandibular tumor [7,8]. The biological behavior of the osteosarcoma in the long bones differ with the jaws osteosarcoma.…”