Osteosarcoma of Jaw Masquerading as Calcifying Epithelial Odontogenic Tumour- A Diagnostic Dilemma

Abstract

Osteogenic osteosarcoma is the most widely recognised primary malignant bone tumour involving particularly the appendicular skeleton. Osteosarcoma of jaw including maxillary and mandibular osteosarcoma accounts for about 7% of cases. The variants of osteosarcoma involving jaw include- osteosarcoma, Not Otherwise Specified (NOS) Low grade central osteosarcoma; chondroblastic osteosarcoma; parosteal osteosarcoma; periosteal Osteosarcoma. The present case was a 27-year-old male who came to the dental Outpatient Department (OPD) with the complaints of swelling in the upper vestibule and loosening of upper alveolar teeth and was reported as Calcifying Epithelial Odontogenic Tumour (CEOT) on histopathological examination and excision of the lesion was done. After two months the patient again presented with a recurrent lytic and sclerotic lesion involving the left maxillary bone with soft tissue extension in the maxillary sinus. Provisional diagnosis was made as malignant transformation of CEOT and immunohistochemistry was performed for the confirmation of the diagnosis. This case represented the challenges in the diagnosis of osteosarcoma of jaw which can be due to difficult biopsy procedure; limited imaging and challenges in legitimate resection because of the proximity to essential structures and the challenges are being faced to get the optimal treatment of jaw osteosarcoma.