Osteogenic sarcoma of the mandible

Abstract

0 steogenic sarcoma of the mandible is not common. Often the initial signs are loose teeth, the presence of a jaw mass, numbness of the lower lip, and pain in the jaw. The lesion occurs more frequently in males than in females. It may occur at any age, but the average age is 33 years. Differential diagnosis should include chondrosarcoma, fibrosarcoma, fibrous dysplasia, ossifying fibroma, and giant-cell granuloma .e Jaw sarcomas have been treated with diathermy, radiotherapy, chemotherapy, conservative resection, radical resection, or a combination of these.2-5* 7 Radical resection is believed to give the best chance of cure and is the treatment of ch0ice.l Following ablation, the question of primary reconstruction should be considered on an individual basis. The decision will depend on the condition of the patient, the size and behavior of the tumor, and the tissue available for the safe replacement of tissue. The iliac crest is favored as the bone donor site.l Metastases, if present, usually spread by the bloodstream, but in 7 per cent of the reported cases there was metastatic disease in the suprahyoid lymph nodes. Recurrent or metastatic disease usually occurs in the first posttreatment year, and the survival rates range from 5 to 50 per cent.5f 7* g In the first case to be presented here the lesion is classified as osteogenic sarcoma because of the presence of osteoid. Even though the predominant cell is the chondroblast, it is classified as a chondroblastic osteogenic sarcoma. In the second case the predominant cell is the osteoblast, and this tumor is classified as an osteoblastic osteogenic sarcoma. Had the fibroblast been the predominant cell, with the presence of osteoid, the diagnosis would have been fibroblastic osteogenic sarcoma.