Abstract
Objective: This paper reports a case of mandibular ramus parosteal osteosarcoma, discussing diagnostic problems and reviewing treatment variations. Methods: A 37 year old male patient was referred by a private hospital with a history of abscesses treatment and removal of his right lower molar 1.5 years ago. The wound in his tooth socket was not healed. Swelling with abscesses recurred and was diagnosed as osteomyelitis. The Orthopantomogram (OPG) result showed a description of osteomyelitis, and the Multi Slice Computed Tomography (MSCT) 3D confirmed the suspected osteosarcoma. Histopathologic results indicated parosteal osteosarcoma. Result: Hemimandibulectomy and chemotherapy were performed with good results.Conclusion: This parosteal osteosarcoma was difficult to diagnosis quickly because the initial image resembled osteomyelitis but it was low grade and rare; therefore, meticulous and accurate diagnosis was deemed necessary. Chemotherapy-combined surgery was thereby performed for treating this parosteal osteosarcoma.
Highlights
Osteosarcoma is a malignant neoplasm that commonly occurs in the long bones
Osteosarcoma arises from an osteogenic matrix[3] derived from the mesenchymal cells[4,5] with the presence of osteoid-forming atypical cells within the protein matrix produced by bone cells.[1]
Parosteal osteosarcoma is often misdiagnosed as a benign fibrous lesion while it is generally fibrous dysplasia.[2,8]
Summary
Osteosarcoma is a malignant neoplasm that commonly occurs in the long bones. Its predilection refers to distal femoral metaphysis, proximal tibia, and humeral metaphysis while the predilection on the mandible, maxilla, rib, vertebra, hand and foot bone is rare.[1,2]Osteosarcoma arises from an osteogenic matrix[3] derived from the mesenchymal cells[4,5] with the presence of osteoid-forming atypical cells within the protein matrix produced by bone cells.[1]. In 1961, Som and Peimer first described parosteal osteosarcoma in the jaw and reported only 12 cases in the literature.[8]
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