Paget's disease with osteogenic sarcoma of maxilla

Abstract

Paget's disease reaches its greatest height of destructive activity in later life. The onset is insidious, and often patients are unaware of any disorder until routine roentgenograms reveal the presence of hyperostosis or the bones of the face and jaws become noticeably altered. Cystic spaces are frequently seen, due to liquefaction of the connective tissue and bone, and profuse hemorrhage is often encountered during surgery. Persons afflicted with Paget's disease have been found to have a high incidence of osteogenic sarcoma. Some microscopic sections of bone may present a benign Paget's lesion and also show sarcomatous degeneration arising in the same area. The therapeutic results of osteogenic sarcoma in general are poor. Radiotherapeutic methods will have to be improved if satisfactory control of the disease is to be achieved. In the aged and feeble patient with an advanced lesion, palliation is all that can be offered. The oral surgeon should be familiar with the diagnosis and treatment of such disorders, especially those involving the face and jaws, and he should see to it that the patient receives proper treatment. It cannot be overemphasized that early recognition and prompt institution of treatment are vital.