Osteosarcoma Of Jaw Research Articles

OSTEOSARCOMA OF THE ANTERIOR MAXILLA: CONTRIBUTION OF THE DENTAL TEAM IN THE DIAGNOSIS AND IMMEDIATE REHABILITATION

Tumors of jaw are among the most uncommon of all types of neoplasms. Osteosarcoma of the jaw represents a distinct group of lesions from the common type often occurring in long bones, which rarely affects the anterior maxilla. A 43-year-old male patient with a previous history of dental losses in the anterior maxilla region and biopsy results without conclusive diagnosis for 18 months attended the oral medicine service complaining of an asymptomatic hard nodule in the anterior maxilla. An incisional biopsy was performed, and diagnosis was chondroblast osteosarcoma. The patient was referred to the oncologist and head and neck surgeon, received 3 cycles of chemotherapy with cisplatin and doxorubicin, maintained stable disease, and then underwent conservative maxillectomy. The surgical planning included the collaboration of the dental team, with installation of immediate removable maxillary obturator prostheses, allowing the patient more comfort postoperatively and improving in speech, swallowing, and esthetics.

The Use of Elastic Bandage in the Treatment of Palpebral Ptosis in a Patient after Resection of Osteosarcoma of the Jaw

AbstractCraniofacial osteosarcomas represent 5 to 10% of primary bone malignancies, with greater predominance in the mandible and maxilla, being classified as primary (idiopathic) or secondary (predisposed to direct exposure). Patients with this pathology have increased soft tissue and bone pain, being the treatment based on the surgical resection of the tumor and rehabilitation after withdrawal to the possible consequences of the intervention. Currently, the use of the elastic bandage has been used in various neuromuscular and musculoskeletal dysfunction, inhibiting or activating the muscles for improved function. The objective of this study was to demonstrate the influence of the use of the elastic bandage in a patient after resection of osteosarcoma of the jaw, with sequel of bilateral palpebral ptosis. Type of study: adult neurology. Clinical case, patient, female, 29 years old, with bilateral palpebral ptosis 5 days after resection of osteosarcoma of the jaw. It was observed falling of bilateral palpebra in the inspection, and muscle weakness on the same muscle (grade 1). After 2 months after surgery physiotherapy was started, being submitted to sessions of facial kabat associated to the use of the elastic bandage for activation of the eyelid levator muscle, using the technique in I, by the Therapy Taping Method. 12 sessions of physiotherapy were carried out, and at the end of the proposed period, the patient was reassessed. Elevation of the eyelid and increased muscle strength (grade 1 to 3) was observed. It is concluded that the use of the elastic bandage in a patient after resection of osteosarcoma of the jaw with sequel of palpebral ptosis was shown to be efficient in improving the clinical signs. Keywords: Mandible. Blepharoptosis. Athletic Tape. ResumoOsteosarcomas crâniofaciais representam 5 a 10% das malignidades osseas primarias, com maior predominio em mandibula e maxila, sendo classificada em primarias (origem idiopatica) ou secundarias (predispostas a exposicao direta). Os pacientes com esta patologia possuem aumento de tecidos moles e dor ossea, sendo o tratamento baseado na resseccao cirurgica do tumor e reabilitacao pos retirada visando as possiveis sequelas da intervencao. Atualmente o uso da bandagem elastica tem sido utilizado para em diversas disfuncoes neuromusculares e musculoesqueleticas, inibindo ou ativando a musculatura para melhora da funcao. O objetivo do estudo foi demonstrar a influencia do uso da bandagem elastica em uma paciente pos resseccao de osteosarcoma mandibular, com sequela de ptose palpebral bilateral. Tipo de estudo: neurologia adulto. Caso clinico, paciente, sexo feminino, 29 anos, com ptose palpebral bilateral 5 dias pos resseccao de osteosarcoma mandibular. Observou-se queda da palpebra bilateral na inspecao, e fraqueza muscular do mesmo musculo (grau 1). Apos 2 meses pos cirurgia iniciou fisioterapia motora, sendo submetida a sessoes de kabat facial associado ao uso da bandagem elastica para ativacao do musculo elevador da palpebra, atraves da tecnica em I, pelo Metodo Therapy Taping. Foram realizadas 12 sessoes de fisioterapia, e ao final do periodo proposto, a paciente foi reavaliada. Observou-se elevacao da palpebra e aumento da forca muscular (grau 1 para 3). Conclui-se que o uso da bandagem elastica em uma paciente pos resseccao de osteosarcoma mandibular com sequela de ptose palpebral mostrou ser eficiente na melhora do quadro clinico. Palavras-chave: Mandibula. Blefaroptose. Fita Atletica.

OSTEOSARCOMA OF THE MANDIBLE DEVELOPED AFTER TOOTH EXTRACTION TREATED WITH SURGERY- A CASE REPORT

Osteosarcoma of jaw is a rare malignant condition of osteoid tissue with same histopathological features but different biological behaviour compared to long bone. It has characteristic clinical, radiographic and histopathologic features and treatment after early diagnosis followed by surgery (with negative margin) combined with chemotherapy or radiotherapy has better prognosis and survival rate. Here we report the case of osteosarcoma of mandible after tooth extraction in a 55-year-old female and treated by surgery.

Osteosarcoma of the Mandible Developed After Tooth Extraction Treated With Surgery- A Case Report

Osteosarcoma of jaw is a rare malignant condition of osteoid tissue with same histopathological features but different biological behaviour compared to long bone. It has characteristic clinical, radiographic and histopathologic features and treatment after early diagnosis followed by surgery (with negative margin) combined with chemotherapy or ra­diotherapy has better prognosis and survival rate. Here we report the case of osteosarcoma of mandible after tooth extraction in a 55-year-old female and treated by surgery

OSTEOSARCOMA OF THE JAWS DURING PREGNANCY: CASE REPORT AND REVIEW OF THE LITERATURE

Osteosarcoma of jaw bones represents less than 1% of all head and neck malignancies. Malignancy in pregnant women is also an uncommon event, and occurs in a ratio of one case per 1000 deliveries. The aim of this study is to report a rare case of maxillary osteosarcoma in a pregnant woman, and to review the previous cases published in English literature. A 29-year old woman, in the 33rd week of gestation, presented with a 2.5 cm reddish, multilobulated and ulcerated nodule in posterior maxilla with 1 month of evolution. Computerized tomography showed an expansive tumor destroying the alveolar bone around the molars and invading the maxillary sinus. The material of the first incisional biopsy was not enough to conclude the diagnosis. Before a second biopsy was done, the patient delivered normally a healthy boy. Histologically, the tumor was composed by round cells with prominent cytoplasm and pleomorphic nuclei, sometimes multinucleated. Areas with spindle and epithelioid cells were also found, among osteoid or chondroid matrix. The lesion was extremely vascularized, with mixomatous and telangiectatic regions. The final diagnosis was conventional osteosarcoma, and the lesion was surgically removed, with clear margins. A microsurgical flap was used for reconstruction and the patient received adjuvant radiation and chemotherapy. She has been followed up for one year, with no signs of metastasis or recurrence. The influence of pregnancy on the initiation, promotion and development of sarcomas is not well established. To the best of our knowledge, no more than 10 cases of jaw osteosarcoma in pregnant women have been reported up to now. The co-existence of malignancy and pregnancy is very uncommon, and sometimes a challenge for medical professionals, especially regarding the diagnosis, the use of ancillary examinations and the treatment.

Jaw osteosarcoma models in mice: first description

BackgroundOsteosarcoma (OS) is the most common cancer of bone. Jaw osteosarcoma (JOS) is rare and it differs from other OS in terms of the time of occurrence (two decades later) and better survival. The aim of our work was to develop and characterize specific mouse models of JOS.MethodsSyngenic and xenogenic models of JOS were developed in mice using mouse (MOS-J) and human (HOS1544) osteosarcoma cell lines, respectively. An orthotopic patient-derived xenograft model (PDX) was also developed from a mandibular biopsy. These models were characterized at the histological and micro-CT imaging levels, as well as in terms of tumor growth and metastatic spread.ResultsHomogeneous tumor growth was observed in both the HOS1544 and the MOS-J JOS models by injection of 0.25 × 106 and 0.50 × 106 tumor cells, respectively, at perimandibular sites. Histological characterization of the tumors revealed features consistent with high grade conventional osteosarcoma, and the micro-CT analysis revealed both osteogenic and osteolytic lesions. Early metastasis was encountered at day 14 in the xenogenic model, while there were no metastatic lesions in the syngenic model and in the PDX models.ConclusionWe describe the first animal model of JOS and its potential use for therapeutic applications. This model needs to be compared with the usual long-bone osteosarcoma models to investigate potential differences in the bone microenvironment.

Triple primary malignancies of surface osteosarcoma of jaw, myelodysplastic syndrome and colorectal cancer as a second primary cancer detected by PET2‑[18F]‑fluoro‑2‑deoxy‑D‑glucose positron emission tomography: A case report

Second primary malignancy (SPM) is a severe issue for cancer survivors, particularly for osteosarcoma (OS) survivors. To date, the associations between subsequent SPM and OS have been well reported. Hematogenic and solid malignancies tend to occur following OS treatment. Reportedly, 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) is mainly used in OS patients for initial cancer staging, to evaluate the response of neoadjuvant chemotherapy, and when recurrence or metastasis is clinically suspected. The present case report describes a 70-year-old man diagnosed with three primary malignancies: jaw OS, myelodysplastic syndrome and colorectal adenocarcinoma. To the best of our knowledge, this combination of malignancies has not been reported previously. Until now, there is no specific protocol of postoperative FDG-PET for OS patients. Few studies have described OS follow-up methods; therefore, there is no consensus on proper follow-up methods. In the present case report, the colorectal early-stage SPM was observed, without any symptoms, by FDG-PET/computed tomography. To avoid overlooking solid SPMs, it is suggested that FDG-PET should be performed in the long-term follow-up of OS patients.

Osteosarcoma of jaws: An insight into literature

Osteosarcoma (OS), referred to as osteogenic sarcoma, is the most common primary malignant bone tumor excluding plasma cell tumors. It accounts for approximately 15% of all primary bone tumors confirmed at biopsy. It commonly involves the appendicular skeleton. Like, its counterpart in the long bones, OS affecting the head-and-neck region shows the distinct yet diverse clinical, histologic, and prognostic characteristics. Its diagnosis is a challenge to oral pathologists and is especially important in early stages to improve its prognosis. The data have been taken from the published articles and standard books and are summarized. In this review, in addition to summarizing the current understanding of OS etiology and diagnostic methods, various experimental therapeutics have been described that provides evidence to encourage a potential paradigm shift toward the introduction of immunomodulation, which may offer a more comprehensive approach to battling cancer.

Craniofacial Osteosarcoma: A Case Report and Brief Review of the Literature

Craniofacial osteosarcoma is a relatively rare entity comprising about 6.5–7% of all osteosarcomas, whereas it is reported to be one of the most common malignancies of long bones. Osteosarcoma (OS) is a malignant mesenchymal tumor whose cancerous cells produce osteoid matrix. Jaw lesions are diagnosed on average two decades later than sarcomas of long bone, with a peak incidence between 20 and 40 years. Considerable histopathologic variability is seen in jaw OS, which includes osteoblastic, chondroblastic and fibroblastic types. Head and neck OS is associated with a lower metastatic rate than long bone OS, and they have a better 5-year survival rate. Here we present a case of chondroblastic variant of osteosarcoma (COS) of the mandible in a 23 year-old-boy.

Osteosarcoma: A rare case report and review of literature

Osteosarcoma of the jaws is a rare, aggressive, malignant mesenchymal tumor with an estimated incidence of 5% in 100,000 of the new cases per year. Osteosarcoma of jaws is a very rare disease and may constitute approximately 1% of all head and neck cancers and only 0.14% of intraoral malignancies. Approximately 7% of all osteosarcomas arise in the jawbones. Diagnosis of the tumor is important, especially in early stages for improving prognosis. Here, we report a rare case of osteosarcoma of chondroblastic variant in a 20-year-old girl, who presented with a bony swelling in the right mandibular posterior region, with a radiographic presentation of sunburst appearance, and the histopathological examination confirmed the diagnosis.

Osteosarcoma of Mandible

ABSTRACTOsteosarcomas (OS) are malignant neoplasms of the bone that commonly affect the long bones with rare presentation in jaws. Osteosarcomas of jaws represent about 6 to 8% of all OS, with an incidence of approximately 1 in 1.5 million persons per year. Although the exact cause of OS is still unknown, defects in the retinoblastoma (RB) and p53 genes play an important role in the process. It is characterized histologically by anaplastic stroma with direct osteoid production. Here, we report a case of OS in a 30-year-old female, who came with a massive bony swelling in the right mandibular region.How to cite this articleBhatt SS, Patel S, Pathak J, Swain N. Osteosarcoma of Mandible. J Contemp Dent 2016;6(1):70-74.

Osteosarcoma of Jaw - Case Report and Review of Literature

Osteosarcoma is a bone tumor and can occur in any bone, usually in the extremities of long bones, near the metaphyseal growth plates. Osteosarcoma of the jaw bones represents a distinct group of lesions from the conventional type commonly occurring in long bones. The emphasis should be laid on the aggressiveness of this lesion which warrants an early identification and diagnosis of the lesion followed by prompt treatment. True synchronous multicentric osteosarcomas of the jaws are extremely rare but, like other osteosarcomas of the jaws, have a favourable outcome, and palliative resection of such lesions, though challenging, can therefore lead to an enormously improved quality of life and self-image, and may even offer the opportunity for cure. We present a case of osteosarcoma of mandible in a young male treated by radical excision and reconstruction using free fibula bone flap.

Maxillary Osteosarcoma with Fibrous Dysplasia of Frontal Bone – A Rare Case Blog

Introduction: Osteosarcoma is the primary malignancy of bone which accounts for 15-20% of all the primary bone tumours. Osteosarcomas of Head and neck is a relatively rare tumour and accounts for 10% of all osteosarcomas [1]. The mean age of occurrence of this tumour is fourth decade. Diagnosis is mainly based on the CT scan, which also clearly describes the extent of the disease. Osteosarcomas of jaw differ from osteosarcomas of other long bones in its biological behaviour. Early diagnosis and adequate surgical resection are keys for high survival rate. This paper documents a rare presentation in which there is osteosarcoma of the maxilla with fibrous dysplasia of frontal bone, dual presentation in the same patient. Case Blog: A twenty two years male patient came to the Department of ENT and Head Neck surgery with complaints of left sided cheek swelling, left sided nasal obstruction, watering of let side eye for the past four months. There was also occasional historyof nasal bleeding from left side for the same period and loosening of left upper jaw teeth. On clinical examination there was hard swelling (7cm × 5 cm), fixed to skin and deeper tissues. Another hard swelling (3 cm × 2 cm) was present over the right side eye brow, not fixed to the overlying skin. No paraesthesia or loss of sensation was present over left side cheek or over the right side forehead region. Proptosis of left side was present. There was no fluctuation, visible pulsation or hyperpigmentation seen. It was not compressible or reducible. There were no signs of ulceration or sinus formation. CT scan of Para nasal sinuses findings was left maxillary antrum showing “sun burst” opacification (Figures 1 and 2). Left nasal cavity was occluded and left orbit was encroached upon by mass. Those findings were suggestive of osteosarcoma. Frontal bone was having the classical “ground glass appearance” suggestive of fibrous dysplasia of the bone. As maxillary region swelling was more suggestive of sarcoma, it was taken as prime importance and treatment was planned accordingly. Endoscopy assisted biopsy of the mass was planned first. Biopsy from the left nasal cavity showed spindle shaped and polygonal cells with large hyper chromatic nuclei. Tumour cells showed marked nuclear pleomorphism and osteoid production, multi nucleated cells with bizarre hyper chromatic nuclei and mitotic figures were found. Histopathological findings were suggestive of osteosarcoma. Left sided total maxillectomy was done preserving left eye (Figures 3 and 4) .Specimen was sent for histopathological examination and histopathological report confirmed it to be osteosarcoma. The patient was sent to oncology department for further management and was followed up regularly. Right side frontal bossing was looking more a kind of fibrous dysplasia with the classical ground glass appearance in CT scan; hence observation and conservative management was planned. The patient went for chemotherapy and regular follow-up was done every 3months. Discussion: Osteosarcomas being the rare primary bone tumour of the Head and Neck easily can be left undiagnosed or underdiagnosed. The most common presentation of osteosarcomas is painless hard swelling, associated with epistaxis, nasal obstruction, loosening teeth, eye problems [2]. In our case also patient had all these problems. As it was a painless swelling patient was not so much worried, and this lead to delay in diagnosis. The differential diagnoses that we should keep in our mind when we are diagnosing osteosarcoma are chondrosarcoma, Ewing’s sarcoma, metastasis, fibrous dysplasia, rhabdomyosarcoma [2]. The diagnosis was done in this patient, because of the classical sunburst appearance in the CT scan [3]. This bony swelling started as a painless progressive swelling and the duration was only 4 months. Because of its rapid progression, this was thought to be more a kind of malignant tumour, rather than inflammatory swelling. Also, radiology and histology studies were more in favour of osteosarcoma. After histopathological confirmation, Patient was started on chemotherapy. Patient was regularly followed up in our department in 3rd month and 6th month. There was no recurrence of tumour noted Conclusion: Osteosarcomas of head and neck are very rare. When one physician is encountering a bony hard painless swelling rapidly progressing in nature, with complaints of eyes, loosening of teeth, one should always keep in mind the chances of primary bone tumour of the Jaw. Though incidence of these tumours is found to be rare, there are possibilities of these sarcomas, and if early diagnosis is not done in these patients, prognosis is found to be very bad.

Local invasion of jaw osteosarcoma

Introduction: One of the most common primary malignant bone tumor is osteosarcoma that counts high percentages in the level of incidence the 5% of all tumor in children, and the 9% of all sarcomas. Osteosarcoma are malignant bone tumors developing from mesenchymal tumor cells that growth as disorganized immature bone or osteoid tissue. Patients affected by osteosarcoma show a peak incidence related to puberty (for young female 12±2 years and

Obturator prostheses in post-oncological maxillofacial patients: our experience

Background: Surgical procedures for tumors of the paranasal sinus, palatal epithelium, minor salivary glands or osteosarcoma of theupper jaw require a partial or total maxillectomy of the upper jaw. When the surgical procedure and/or radiation therapy result in acommunication, the solution is necessarily prosthetical, through a palatal obturator that recreates a partition between the oral andnasal cavities.Methods: Authors selected 32 post-oncological patients with the upper maxilla completely edentulous prosthetically rehabilitatedwith a palatal obturator.Results: No serious complications or adverse reactions were reported during the fabrication of surgical or definitive obturators. Allpatients stated to benefit the palatal obturator in terms of quality of life.Conclusion: Prosthetic rehabilitation of edentulous maxillectomy with oral communication is a demanding challenge for theprosthodontist. The goals of prosthetic rehabilitation include separation of oral and nasal cavities to allow adequate deglutition andarticulation of teeth, restore midfacial soft tissue contour and a satisfactory esthetic outcome. When, for any reason, the patient is nota suitable candidate for an implant-retained overdenture, a total removable prosthesis should ensure the most comfort in terms ofswallowing, phonation and aesthetics.

Multimodality treatment of osteosarcoma of the jaw: a single institution experience.

Osteosarcomas of the jaws are rare mesenchymal tumors frequently diagnosed in the fourth decade of life which account for 6 % of all osteosarcomas. This study evaluated the efficacy on the patients outcome of multimodality treatment consisting of surgery, chemotherapy and radiotherapy. The records of 22 patients affected by jaw osteosarcoma treated with a combination of surgery, poly-chemotherapy and adjuvant radiotherapy in selected cases were reviewed. Response rate, progression-free survival and overall survival were evaluated. Neoadjuvant chemotherapy resulted in an overall response rate of 83.3 %, necrosis of grade I or II was obtained, respectively, in 44.4 and 55.6 % of the patients, and surgery was radical in all patients. At a median follow-up of 60 months, the 5-year progression-free survival and overall survival were 73.5 and 77.4 %, respectively. These outcome parameters significantly correlated with age at diagnosis and grade of chemotherapy-induced necrosis. A complex multimodality approach including chemotherapy and radiotherapy, along with radical surgery, can maximize the outcome of patients affected by osteosarcoma of the jaws.

Osteosarcomas of jaw: Experience of a single centre

Although osteosarcoma is the most common primary malignant tumour of bone, osteosarcomas of jaw are rare. In osteosarcomas of jaw, evaluating the clinicopathological factors affecting the prognosis is not easy because of different approaches to diagnosis, treatment, and follow-up. This study reviewed 14 cases of JOS that were diagnosed between 1990–2010, in terms of age, gender, site, clinical history, histopathologic type and histopathologic grade, treatment, and prognosis. Median age was 35 years, while male:female ratio was 1.8:1. Eight tumours were located in the mandible. Osteoblastic differentiation was the predominant feature in seven cases followed by chondroid osteosarcoma (four cases), fibroblastic osteosarcoma, low-grade (parosteal) osteosarcoma associated with fibrous dysplasia, and postradiation osteosarcoma (one cases each). During follow-up, recurrence was seen in four patients at least once and they all died. In conclusion, early diagnosis and complete resection seems to be effective in prognosis. Therefore, clinicians and pathologists should be aware of its characteristics and main differential diagnosis to avoid late recognition.

The radiation-induced jaw osteosarcoma: CT imaging features

To evaluate the CT features of radiation-induced jaw osteosarcoma(RIJOS) developed after therapeutic irradiation for a variety of nonosseous lesions. The demographic and CT findings of thirteen patients with RIJOS were reviewed retrospectively.Observation items included location, bone destruction, mineralized tumor matrix, periosteal reaction, soft tissue extension and calcification.Of the thirteen patients, twelve were male and one was female. The mean age was 48 years (range: 29-68 years).Five patients had tumors in the maxilla and eight in the mandible. All the patients underwent tumor resection. The latent period before development of RIJOS ranged from 3.5 to 14 years (mean, 11 years).In all thirteen patients, eight tumors were osteoblastic, with one osteolytic and four mixed lesions.Osteoid tumor matrix mineralization was present in twelve patients. Periosteal reaction was identified in 11 cases.Soft-tissue extension was present in all patients beyond the area of bone destruction. The characteristic CT imaging of RIJOS showed the bone destruction associated with a large number of mineralized tumor matrix and significant soft tissue extension in the original radiation field after radiotherapy. CT findings could play an important role in identifying the tumor and pre-operative assessment.

Osteosarcoma of mandible: Detailed radiographic assessment of a case

Osteosarcoma (OS) is a malignant connective tissue tumor originating from bone and is the most common primary bone malignancy of long bones but seldom arises in jaw bones. Osteosarcoma of jaws is frequently seen arising in the second and third decade as compared to earlier occurrences in other bones and show a slight predilection for body of mandible. It is a highly malignant tumor with varied radiographic features. We present a case with detailed radiographic assessment using intraoral radiograph, computed tomography (CT), 3-D CT, CT angiography techniques and histological evaluation.

Osteosarcoma of the maxilla: A case report and review of literature

Osteosarcoma (OS) is the most common primary bone tumor of the jaw. It is rare, and the biological behavior differs from other skeletal bone tumors. OS of jaw is characterized by lower incidence of metastasis and better prognosis than OS of long bones. Surgery with adjuvant radiotherapy is the mainstay of treatment. The complicated three-dimensional anatomy of the head and neck region makes it difficult to obtain wide resection margins, leading to higher chances of recurrence. Death is usually caused by the uncontrollable local spread. We present a case of 61-year-old man with diabetes mellitus, who presented with an upper jaw swelling, which was histologically confirmed as OS of the maxilla. He underwent surgery and adjuvant radiation for the same. 1 year later, patient developed recurrence at the base of the skull which was inoperable. He received palliative chemotherapy for the same and is now under follow-up.