Abstract
Osteosarcoma of the jaws (OSJ) comprise 6% of total cases of osteosarcoma. With the goal of better characterizing these tumors, we reviewed the files at the Oral Pathology Lab, NYPQ from 1984-2021 and identified 23 cases of OSJ. Of the 23 cases, a male predilection (56.5%) was identified with peak ages occurring in the 3<sup>rd</sup> (22%) and 6<sup>th</sup> (26%) decades. Seventeen cases were intramedullary, 6 cases in the maxilla and 11 in the mandible. One maxillary and 2 mandibular lesions were described as gingival lesions attached to the bone, but medullary or periosteal origin could not be determined. Three lesions were reported as gingival soft tissue masses. Intramedullary OS demonstrated a mandibular (64.7%) predilection with most occurring posteriorly (81.8%). Clinical impressions ranged from benign to malignant. Paresthesia (8.7%), pain (13.0%) and bony swelling (43.5%) were the most common presenting features. Four cases had been previously treated by either endodontic therapy, extraction or incision and drainage. Radiographs were not retrievable for all cases, but 3 cases were described as radiolucent, 1 as radiopaque and 1 with calcifications. Histologic subtypes included osteoblastic (15), chondroblastic (7), and fibroblastic (1). The osteoblastic OS had a male predilection (60.0%), while the chondroblastic OS had a female (57%) predilection. The fibroblastic OS occurred in a male. The osteoblastic OS age range spanned the 3<sup>rd</sup>-8<sup>th</sup> decade with relatively equal distribution. The chondroblastic OS spanned the 2<sup>nd</sup>-6<sup>th</sup>decade with a peak in the 6<sup>th</sup> decade. The fibroblastic OS occurred in the 1<sup>st</sup> decade. Only the osteoblastic OS had clinical presentations of pain and/or paresthesia. OSJ accounts for approximately 1% of all head and neck malignancies but was not included in the differential diagnosis on first presentation of 22 of our 23 cases. Therefore, despite their rarity, we emphasize the importance for clinicians to consider OSJ in their differential diagnosis.
Published Version
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