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Omami G, Yeoh M. Malignant Lesions of the Oral Region. Dent Clin North Am 2024; 68:319-335. [PMID: 38417993 DOI: 10.1016/j.cden.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article focuses on the radiographic presentations of various malignant conditions that affect the oral region and delineates the role of CT, MR imaging, and PET in oral cancer imaging.
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Affiliation(s)
- Galal Omami
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, Department of Oral Health Practice, University of Kentucky College of Dentistry, 770 Rose Street, MN320, Lexington, KY 40536, USA.
| | - Melvyn Yeoh
- Division of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, 770 Rose Street, D-528, Lexington, KY 40536, USA
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Muylaert F, De Kock L, Creytens D, Verstraete K, Coopman R. High-grade osteosarcoma arising in DCIA flap reconstruction after a prior resection of maxillar cemento-ossifying fibroma: A case report. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101591. [PMID: 37558180 DOI: 10.1016/j.jormas.2023.101591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/11/2023]
Abstract
Cemento-ossifying fibroma is a rare benign odontogenic tumour of the tooth-bearing jaws. Its concomitant occurrence with osteosarcoma, a malignant maxillofacial bone tumour, has never been described before. We present an uncommon case of a 43-year-old woman in whom a cemento-ossifying fibroma in the right maxilla was treated by resection and reconstruction using a deep circumflex iliac artery flap. During surgical prosthetic rehabilitation one-year post-operative, an osteosarcoma extending from the contralateral maxilla was coincidentally discovered in the deep circumflex iliac artery flap. The aim of this case report is to raise awareness on the extremely rare but possible simultaneous and independent occurrence of a cemento-ossifying fibroma and an osteosarcoma.
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Affiliation(s)
- Frances Muylaert
- Department of Oro-Maxillofacial, Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Ghent, Belgium.
| | - Lisa De Kock
- Department of Oro-Maxillofacial, Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Ghent, Belgium
| | - David Creytens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium; Department of Diagnostic Sciences and Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium
| | - Koenraad Verstraete
- Department of Diagnostic Sciences and Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium; Head of Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Renaat Coopman
- Department of Oro-Maxillofacial, Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Ghent, Belgium; Department of Diagnostic Sciences and Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium
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Ahuja M, Mandal S, Mallya V, Khurana N, Meher R, Singh K. Osteosarcoma of the jaw: Primary versus secondary - A report of two cases. J Cancer Res Ther 2023; 19:2086-2089. [PMID: 38376327 DOI: 10.4103/jcrt.jcrt_2295_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 01/13/2022] [Indexed: 02/21/2024]
Abstract
ABSTRACT Osteosarcoma (OS) is the most common primary malignancy of bone excluding hematological malignancies. Most common sites of tumor are long bones of extremities. OS of the jaw are extremely rare with mandible being more commonly after than maxilla. Hereby, we present two cases of OS of jaw with one patient being male and other female.
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Affiliation(s)
- Manisha Ahuja
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Shramana Mandal
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Varuna Mallya
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Ravi Meher
- Department of ENT, Maulana Azad Medical College, New Delhi, India
| | - Kishore Singh
- Department of Radiotherapy, Maulana Azad Medical College, New Delhi, India
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Loubna A, Bouchra T. Osteosarcoma of the jaws: A case report. Int J Surg Case Rep 2022; 93:106909. [PMID: 35339036 PMCID: PMC8956793 DOI: 10.1016/j.ijscr.2022.106909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/25/2022] [Accepted: 02/27/2022] [Indexed: 11/03/2022] Open
Abstract
Introduction Osteosarcomas of the jaws are very rare accounting for only 6 to 7% of all osteosarcomas and 1% of all head and neck malignancies. The clinicopathological characteristics as well as the radiological characteristics are not specific, which represents a diagnostic dilemma. Indeed, this lesion is often mistaken for benign lesions of the maxillary. Case presentation We report a case of osteosarcoma of the jaws in a 45 year man who consulted in our service for a simple painless oral swelling evolving since a five months. The lesion was excised and histopathological report confirmed the diagnosis of osteosarcoma of the jaw. Discussion Osteosarcomas are a rarely progressive tumor in the oral cavity that can show up as a case of a benign process of dental origin. During our practice, we often meet similar cases which are treated by usual medication, while a whole malignant process is in the progress and can be life-threatening. The case we present illustrates this perfectly, and owing to a deep clinical investment, the malignant process was stopped at its start. Conclusion The objective of presenting this case is to draw the attention of the doctors that any lesions even of benign appearance can hide a malignant process. Consider this point and integrate it into its diagnostic approach should be undertaken and should lead to a deepening of the clinical examination by comparing the clinical, radiological and histological data. Never underestimate a lesion of usual appearence; a whole malignant process can be hidden. A dippening of clinical and paraclinical investigations is an approch to adopt. Early diagnosis can improve the management of the desease and save lives.
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Sain B, Gupta A, Ghosh S, Mondal RR, Bhattacharya S, Ghose A. Osteosarcoma of the maxilla presenting as a chronic pyogenic abscess: A case report. Int J Surg Case Rep 2021; 87:106425. [PMID: 34560593 PMCID: PMC8473757 DOI: 10.1016/j.ijscr.2021.106425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Osteosarcoma of the maxilla is recorded as the least common of all bone malignancies. It exhibits a clinical behavior and natural history distinct from their counterparts of the trunk and extremities. Transformation from a chronic pyogenic abscess of the maxilla is even more unusual. Case summary A 70 year old lady presented to our hospital with a hard, fixed and tender bony swelling in her left cheek. She had initially presented to a different hospital with a similar presentation which was excised after imaging and post excision was found to be a chronic pyogenic abscess. The swelling reappeared within one year and on re-excision was found to be a low grade paraosteal osteosarcoma of the hard palate. CECT and PET-CT work-up at our hospital showed a left maxillary sinus growth with prominent neck lymph nodes along with mediastinal lymphadenopathy and pulmonary metastasis. Final histopathology revealed ulcerated stratified squamous epithelium mucosa overlying a lesion suggestive of osteosarcoma. Discussion Complete surgical excision with negative margins continues to be the mainstay of treatment, but osteosarcomas of maxillofacial region pose difficulties in obtaining tumour free margins because of their complex anatomy around the cranium. Surgery may be complemented by radiotherapy with or without chemotherapy. Small size of the tumour and low-grade histology have been assumed to reflect a better prognosis. Conclusion Osteosarcoma of maxillofacial region has variable appearance clinically as well as radiologically posing a diagnostic challenge for clinicians. Any chronic abscess or recurrent cheek swelling thus necessitates further suspicion and requires a full work-up to rule out this high risk malignancy. Osteosarcoma of the maxilla is recorded as the least common of all bone malignancies with transformation from a chronic pyogenic abscess of the maxilla being even more unusual. Complete surgical excision with negative margins is the mainstay of treatment for better prognosis complemented with or without adjuvant radiotherapy. Any chronic abscess or recurrent cheek swelling necessitates further suspicion and requires a full work-up to rule out this high risk malignancy.
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Affiliation(s)
- Baijaeek Sain
- Dept. of Surgical Oncology, Saroj Gupta Cancer Centre and Research Institute Kolkata, India.
| | - Arnab Gupta
- Dept. of Surgical Oncology, Saroj Gupta Cancer Centre and Research Institute Kolkata, India
| | - Saradindu Ghosh
- Dept. of Surgical Oncology, Saroj Gupta Cancer Centre and Research Institute Kolkata, India
| | - Radha Raman Mondal
- Dept. of Surgical Oncology, Saroj Gupta Cancer Centre and Research Institute Kolkata, India
| | - Samir Bhattacharya
- Dept. of Surgical Oncology, Saroj Gupta Cancer Centre and Research Institute Kolkata, India
| | - Aruni Ghose
- Solid Tumour Oncology, Barts NHS Trust London, UK
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Tseng CH, Wang WC, Chen CY, Hsu HJ, Chen YK. Retrospective analysis of primary intraosseous malignancies in mandible and maxilla in a population of Taiwanese patients. J Formos Med Assoc 2021; 121:787-795. [PMID: 34531103 DOI: 10.1016/j.jfma.2021.08.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/PURPOSE Due to the rarity and diversity of primary intraosseous malignancies in jawbones, we aimed to evaluate the clinicopathological features and discuss the findings of our collected cases with the literatures. METHODS Twenty-nine patients (2000-2020) diagnosed with primary central malignancies of jawbones were selected from the database of Oral Pathology Department in our institution. Clinical features, radiographic appearance, and histopathological diagnosis of the 29 cases were analyzed. RESULTS Twenty-nine patients aged between 19 and 84 years (average, 57.4 years) with a male to female ratio of 1.2:1 were included. The most frequent site was the mandibular body and ramus, followed by the posterior maxilla and mandibular symphysis. The most common diagnosis was osteogenic sarcoma (n = 13), followed by odontogenic carcinoma (n = 7), hematologic malignancies (n = 5), salivary gland malignancies (n = 2), and neurogenic sarcomas (n = 2). The most frequent symptoms were swelling, pain, paresthesia of lower lip, and mobile tooth. Radiographically, they usually presented as ill-defined osteolytic to osteoblastic lesions depending on the amount of ossification. Wide excision comprising partial maxillectomy and segmental mandibulectomy were the most common therapeutic methods. CONCLUSION Despite the rarity of primary central malignancies in jawbones, the clinical features may mimic infectious process or benign lesions. Detailed history-taking, clinical and imaging examination and awareness of the patient's signs and symptoms combining with the histopathological inspection are important for early diagnosis and improved prognosis. The current data contributes a useful basis for clinical investigation regarding intraosseous malignancies occurring in the jawbones.
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Affiliation(s)
- Chih-Huang Tseng
- Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chen Wang
- Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Yi Chen
- Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Han-Jen Hsu
- Division of Oral & Maxillofacial Surgery, Kaohsiung Medical University Hospital Kaohsiung, Taiwan
| | - Yuk-Kwan Chen
- Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Abdelgalil A. Imaging of the Parotid Impostors. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Holmes KR, Holmes RD, Martin M, Murray N. Practical Approach to Radiopaque Jaw Lesions. Radiographics 2021; 41:1164-1185. [PMID: 34086497 DOI: 10.1148/rg.2021200187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Radiopaque lesions of the jaw are myriad in type and occasionally protean in appearance. In turn, the radiologic analysis of these lesions requires a systematic approach and a broad consideration of clinical and imaging characteristics to enable reliable radiologic diagnosis. Initially categorizing lesions by attenuation pattern provides a practical framework for organizing radiopaque jaw lesions that also reflects important tissue characteristics. Specifically, the appearance of radiopaque lesions can be described as (a) densely sclerotic, (b) ground glass, or (c) mixed lytic-sclerotic, with each category representing a distinct although occasionally overlapping differential diagnosis. After characterizing attenuation pattern, the appreciation of other radiologic features, such as margin characteristics or relationship to teeth, as well as clinical features including demographics and symptoms, can aid in further narrowing the differential diagnosis and lend confidence to clinical decision making. The authors review the potential causes of a radiopaque jaw lesion, including pertinent clinical and radiologic features, and outline a simplified approach to its radiologic diagnosis, with a focus on cross-sectional CT. An invited commentary by Buch is available online. ©RSNA, 2021.
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Affiliation(s)
- Kenneth R Holmes
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - R Davis Holmes
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - Montgomery Martin
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - Nicolas Murray
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
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Sahu B, Anand R, Kumar S, Solanki RS, Mehra P, Jain M. A Pattern-based Imaging Approach to Pediatric Jaw Lesions. Indian J Radiol Imaging 2021; 31:210-223. [PMID: 34316129 PMCID: PMC8299508 DOI: 10.1055/s-0041-1729767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Jaw lesions in the pediatric population, although infrequently encountered in clinical practice, can cause functional impairment and cosmetic disfiguring. It is further complicated by the difficulty in diagnosis due to complex anatomy and facial developmental process during infancy and childhood. Intraosseous pediatric jaw lesions may vary from odontogenic to nonodontogenic types with nonspecific clinical features in most cases. They deserve careful attention by a systematic approach to provide a relevant diagnosis or differential diagnosis for timely management. Imaging plays a major role in diagnosis with orthopantomograph being the foremost investigation, followed by cross-sectional imaging, essentially computed tomography as a problem-solving tool. This article highlights the imaging spectrum of various jaw lesions in the pediatric population with a pattern-based approach for radiological diagnosis.
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Affiliation(s)
- Biswanath Sahu
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Rama Anand
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Sandeep Kumar
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Ravi Shankar Solanki
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Pravesh Mehra
- Department of Dental and Oral Surgery, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Manjula Jain
- Department of Pathology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
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Primary and radiation induced skull base osteosarcoma: a systematic review of clinical features and treatment outcomes. J Neurooncol 2021; 153:183-202. [PMID: 33999382 DOI: 10.1007/s11060-021-03757-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/09/2021] [Indexed: 01/28/2023]
Abstract
PURPOSE We aim to systematically review and summarize the demographics, clinical features, management strategies, and clinical outcomes of primary and radiation-induced skull-base osteosarcoma (SBO). METHODS PubMed, Scopus, and Cochrane databases were used to identify relevant articles. Papers including SBO cases and sufficient clinical outcome data were included. A comprehensive clinical characteristic review and survival analysis were also conducted. RESULTS Forty-one studies describing 67 patients were included. The median age was 31 years (male = 59.7%). The middle skull-base was most commonly involved (52.7%), followed by anterior (34.5%) and posterior (12.7%) skull-base. Headache (27%), exophthalmos (18%), and diplopia (10%) were common presenting symptoms. Sixty-eight percent of patients had primary SBO, while 25% had radiation-induced SBO. Surgery was the main treatment modality in 89% of cases. Chemotherapy was administered in 65.7% and radiotherapy in 50%. Median progression-free survival (PFS) was 12 months, and the overall 5-year survival was 22%. The five-year survival rates of radiation-induced SBO and primary SBO were 39% and 16%, respectively (P < 0.05). CONCLUSION SBO is a malignant disease with poor survival outcomes. Surgical resection is the primary management modality, in conjunction with chemotherapy and radiotherapy. Radiation-induced SBO has a superior survival outcome as compared to its primary counterpart. Complete surgical resection showed a statistically insignificant survival benefit as compared to partial resection.
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Ricotta F, Bassi M, Tomasetti N, Campobassi A, Maiolo V, Bertoni F, Bacchini P, Marchetti C, Tarsitano A. Osteosarcoma of the Jaws: A Literature Review. Curr Med Imaging 2021; 17:225-235. [PMID: 32767948 DOI: 10.2174/1573405616666200806173948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/30/2020] [Accepted: 06/17/2020] [Indexed: 11/22/2022]
Abstract
Osteosarcoma of the jaws (OSJ) is a relatively rare disease, accounting for between 2% and 10% of all cases of osteosarcoma. It is morphologically and radiologically identical to the trunk and extremity variant, but distinct in several crucial aspects. The lesion is characterized by sarcomatous cells which produce a variable amount of osteoid bone. It arises centrally within the bone and can be subdivided into osteoblastic, chondroblastic and fibroblastic subtype, depending on the predominant cell type. Radiographically, these tumors display a spectrum of bone changes from well-demarcated borders to lytic bone destruction with indefinite margins and variable cortical bone erosion or, in some cases, images of sclerotic bone. Therapeutic options for OSJ include surgery, chemotherapy and radiotherapy, which are employed according to age of the patient, histological classification and localization of the tumor. Today, there is no general consensus in the treatment guidelines for the OSJ though surgery represents the key to the treatment. The main prognostic factor deeply influencing the patient's prognosis remains the complete tumor resection with negative surgical margins. The aim of the present review is to describe state of the art regarding diagnostic and surgical treatment aspects of the primary osteosarcoma of the jaws.
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Affiliation(s)
- Francesco Ricotta
- Oral and Maxillofacial Surgery Unit, Azienda Ospedaliero-Universitaria di Bologna, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Massimo Bassi
- Maxillofacial Surgery Unit, Bufalini Hospital, Cesena, Italy
| | | | | | - Vincenzo Maiolo
- Radiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Franco Bertoni
- Department of Pathology, Villa Erbosa Hospital, Bologna, Italy
| | | | - Claudio Marchetti
- Oral and Maxillofacial Surgery Unit, Azienda Ospedaliero-Universitaria di Bologna, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Achille Tarsitano
- Oral and Maxillofacial Surgery Unit, Azienda Ospedaliero-Universitaria di Bologna, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Pires MD, Martins JNR, Dias GS, Doutel D, Ordinola-Zapata R. Osteosarcoma of the anterior maxilla mimicking a periapical pathology: A case report. AUST ENDOD J 2021; 47:656-663. [PMID: 33604945 DOI: 10.1111/aej.12491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/14/2021] [Accepted: 02/03/2021] [Indexed: 01/24/2023]
Abstract
Osteosarcomas of the jaws (OSJ) are difficult to diagnose, rare malignant lesions, with uncharacteristic radiographic and clinical presentation. Early diagnosis and treatment are essential to improve long-term prognosis. The current report presents a rare case of a primary conventional osteoblastic osteosarcoma of the anterior maxilla in a 25-year-old female. She presented to a private dental clinic after developing pain, facial oedema and palpation tenderness of a mass associated with the upper right lateral incisor. The signs and symptoms mimicked very closely a regular radiolucent and symptomatic periapical pathology, and the definitive diagnosis was only possible through a combination of clinical, radiographic and histopathological findings. The patient was referred to an oncology facility, where she was submitted to radical excision surgery through a hemi-maxillectomy. Although other pathologies are uncommon, the differential diagnosis of lesions compatible with odontogenic periapical pathology should not be neglected.
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Affiliation(s)
| | - Jorge N R Martins
- Faculdade de Medicina Dentaria, Universidade de Lisboa, Lisboa, Portugal
| | | | - Delfim Doutel
- Serviço de Anatomia Patológica (SAP), Instituto Português de Oncologia (IPO), Lisboa, Portugal
| | - Ronald Ordinola-Zapata
- Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, MN, USA
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Salamon NM, Casselman JW. Temporomandibular Joint Disorders: A Pictorial Review. Semin Musculoskelet Radiol 2020; 24:591-607. [PMID: 33036046 DOI: 10.1055/s-0040-1701631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Temporomandibular joint (TMJ) disorders are commonly encountered in the general population but often ignored or unrecognized. The detection and characterization of lesions has drastically improved over the years due to technological advances in cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). However, adequate knowledge of the normal imaging appearance on different imaging modalities as well as the broad variety of pathology is required to provide a proper radiologic assessment. This pictorial review focuses on TMJ pathology and its appearance on CBCT and MRI. A short overview of the technical aspects and normal anatomy are provided to round out this complete summary on the subject.
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Affiliation(s)
- Nicolas M Salamon
- Department of Radiology, AZ Sint-Jan Brugge, Bruges, Belgium.,Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Jan W Casselman
- Department of Radiology, AZ Sint-Jan Brugge, Bruges, Belgium.,Department of Radiology, Ghent University Hospital, Ghent, Belgium.,Department of Radiology, GZA Sint-Augustinus Antwerp, Antwerp, Belgium
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14
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Luo Z, Chen W, Shen X, Qin G, Yuan J, Hu B, Lyu J, Pan D. CT and MRI features of calvarium and skull base osteosarcoma (CSBO). Br J Radiol 2019; 93:20190653. [PMID: 31746635 DOI: 10.1259/bjr.20190653] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study aims to assess the CT and MRI features of calvarium and skull base osteosarcoma (CSBO). METHODS The CT and MRI features and pathological characteristics of 12 cases of pathologically confirmed CSBO were analyzed retrospectively. RESULTS 12 patients (age range 9-67 years; 3 male, 9 female) were included in the study. Tumours occurred in skull base (7, 58.3%), temporal (4, 33.3%) and frontal (1, 8.3%). Among all, six patients received radiotherapy for nasopharyngeal carcinoma. According to pathology, 11 out of 12 tumours were high-grade (91.7%). On CT, all the tumours had soft tissue mass penetrated into cortical bone with invasion of surrounding soft tissue. Six tumours were shown to have lytic density and six were mixed density. Matrix mineralization was present in 10 cases (83.3%). On MRI, tumours presented as soft-tissue masses measuring 5.9 ± 2.4 (3.9-8.0) cm. Five tumours showed low signal intensities on T1 weighted imaging with seven having heterogeneous signal intensities. One showed low signal intensity on T2 weighted imaging, two showed high signal intensities and nine heterogeneous signal intensities. All the tumours showed low signal intensities on diffusion-weighted imaging. On contrast enhanced images, seven cases showed heterogeneous enhancement, three showed peripheral enhancementand and two showed homogeneous enhancement. Dural tail sign were detected in nine cases. CONCLUSION CSBO is rare, and is commonly associated with previous radiation exposure. A presumptive diagnosis for osteosarcoma should be considered when calvarium and skull base tumours with osteoid matrix and duraltail sign are found. ADVANCES IN KNOWLEDGE CT and MR features of CSBO have not been reported. The study helps to identify CSBO and other sarcomas.
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Affiliation(s)
- Zhendong Luo
- Department of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.,Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Weiguo Chen
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xinping Shen
- Department of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Genggeng Qin
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianxiang Yuan
- Department of Radiology, Foshan traditional Chinese medicine Hospital, Foshan, China
| | - Biying Hu
- Department of Radiology, Foshan first people's Hospital, Foshan, China
| | - Jianxun Lyu
- Department of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Derun Pan
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Luo Z, Chen W, Shen X, Qin G, Yuan J, Hu B, Lyu J, Wen C, Xu W. Head and neck osteosarcoma: CT and MR imaging features. Dentomaxillofac Radiol 2019; 49:20190202. [PMID: 31642708 DOI: 10.1259/dmfr.20190202] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study aims to assess the CT and MRI features of head and neck osteosarcoma (HNO). METHODS 37 HNOs were identified, and the following imaging characteristics were reviewed on CT and MRI. RESULTS A total of 37 patients(age 41.5 ± 15.0 years old; 16 males, 21 females) were included in the study. Tumours occurred in the maxilla (16, 43.2%), mandible (8, 21.6%), skull base (6, 16.2%), calvarium (5, 13.5%), paranasal sinuses (1, 2.7%) and cervical soft tissue (1, 2.7%). 16 patients received radiotherapy for nasopharyngeal carcinoma. Three patients (8.1%) developed osteosarcomas related to a primary bone disease. 16 of the (43.2%) tumours demonstrated lytic density on CT scans, followed by 13 (35.1%) showing mixed density and 7 (18.9%) with sclerotic density. Matrix mineralization was present in 32 (86.5%). 3 out of 24 (12.5%) tumours showed lamellar periosteal reactions, 21 out of 24 (87.5%) showed spiculated periosteal reactions. 12 tumours showed low signal intensities on T1WI, with 16 having heterogeneous signal intensities. 10 tumours showed high signal intensities on T2WI, and 18 showed heterogeneous signal intensities. With contrast-enhanced images, 3 tumours showed homogeneous enhancement (2 osteoblastic and 1 giant cell-rich), 18 tumours showed heterogeneous enhancement (13 osteoblastic, 4 fibroblastic and 1 giant cell-rich), and 7 tumours showed peripheral enhancement (6 chondroblastic and 1 osteoblastic). These tumours were characterized by soft tissue masses with a diameter of 5.6 ± 1.8 cm. CONCLUSIONS HNO is a rare condition and is commonly associated with previous radiation exposure. This study provides age, sex distribution, location, CT and MRI features of HNO.
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Affiliation(s)
- Zhendong Luo
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Weiguo Chen
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xinping Shen
- Department of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Genggeng Qin
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianxiang Yuan
- Department of Radiology, Foshan traditional Chinese medicine Hospital, Foshan, China
| | - Biying Hu
- Department of Radiology, Foshan first people's Hospital, Foshan, China
| | - Jianxun Lyu
- Department of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Chanjuan Wen
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Weimin Xu
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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16
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Liu Y, Li K. Solitary plasmacytoma of maxillofacial bones: correlation of CT features with pathological findings. Dentomaxillofac Radiol 2019; 49:20190277. [PMID: 31559843 DOI: 10.1259/dmfr.20190277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To explore the CT features of solitary plasmacytoma (SP) of maxillofacial bones and correlation with pathological findings. METHODS AND MATERIALS We retrospectively reviewed the clinical, CT and pathological features of SP in the maxillofacial bones. 16 patients with clinically and histologically proven SP of maxillofacial bones were involved. They were aged from 27 to 79 years old (median 55.5 years old), and included 12 males and 4 females (males vs females: 3:1). All patients performed CT examination, in whom 13 patients underwent enhanced scanning and 3 plain scanning. The CT images were assessed for lesion location, size (maximum diameter), shape (round, oval and irregular), boundary (defined and illdefined), bone changes (bone destruction, residual bone, sclerotic margin and periosteal reaction), density of soft tissue mass and enhancement manifestations, and invasion of adjacent structures. RESULTS 13 patients suffered from SP in the mandible, 2 in the zygoma, and 1 in the maxilla and hard palate. The maximum diameter of lesions ranged from 2.4 to 8.2 cm (mean 3.93 ± 1.435 cm). Most lesions were founded as a solitary osteolytic lesions (15/16, 93.75%) with round or ovoid shape (13/16, 81.25%), smooth margin (16/16, 100%) and defined boundary (16/16, 100%) in bone marrow. They destroyed bone cortex (15/16, 93.75%) and had residual bone (10/16, 62.5%), without sclerosis margin (15/16, 93.75%) and periosteal reaction (14/16, 87.5%). They easily formed soft tissue masses (16/16, 100%) and invade adjacent anatomical structures (15/16, 93.75%). The density of lesions was usually uniform (12/16, 75%) with strong enhancement. There was a significant difference in CT values between plain and enhanced scanning [50.75 ± 9.140 Hounfield unit (HU) vs 101.0 ± 28.830 HU; p < 0.001), with the mean difference of CT values 50.25 HU. CONCLUSIONS SP is predominant in the mandible of elderly male patients. A solitary, round or ovoid, well-defined, osteolytic, invasive mass in bone marrow, which destroys bone cortex, has residual bone, no sclerosis margin and periosteal reaction, and shows strong enhancement, is suggestive of this diagnosis.
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Affiliation(s)
- Yu Liu
- Department of Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Kaicheng Li
- Department of Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China
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17
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Tahmasbi-Arashlow M, Barnts KL, Nair MK, Cheng YSL, Reddy LV. Radiographic manifestations of fibroblastic osteosarcoma: A diagnostic challenge. Imaging Sci Dent 2019; 49:235-240. [PMID: 31583207 PMCID: PMC6761061 DOI: 10.5624/isd.2019.49.3.235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/28/2019] [Accepted: 07/17/2019] [Indexed: 12/25/2022] Open
Abstract
Osteosarcoma is the most common primary bone tumor after plasma cell neoplasms. Osteosarcoma has diverse histological features and is characterized by the presence of malignant spindle cells and pluripotent neoplastic mesenchymal cells that produce immature bone, cartilage, and fibrous tissue. Osteosarcoma most frequently develops in the extremities of long bones, but can occur in the jaw in rare cases. The clinical and biological behavior of osteosarcoma of the jaw slightly differs from that of long-bone osteosarcoma. The incidence of jaw osteosarcoma is greater in the third to fourth decades of life, whereas long-bone osteosarcoma mostly occurs in the second decade of life. Osteosarcoma of the jaw has a lower tendency to metastasize and a better prognosis than long-bone osteosarcoma. Radiographically, osteosarcoma can present as a poorly-defined lytic, sclerotic, or mixed-density lesion with periosteal bone reaction response. Multi-detector computed tomography is useful for identifying the extent of bone destruction, as well as soft tissue involvement of the lesion. The current case report presents a fibroblastic osteosarcoma involving the left hemimandible with very unusual radiographic features.
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Affiliation(s)
| | - Kelcie Louise Barnts
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Madhu K Nair
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Yi-Shing Lisa Cheng
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Likith V Reddy
- Department of Oral and Maxillofacial Surgery, Texas A&M University College of Dentistry, Dallas, TX, USA
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18
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Affiliation(s)
| | | | - Shaza Mardini
- University of Tennessee, Graduate School of Medicine, Knoxville, TN
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19
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Omami G. Twenty classic signs in oral and maxillofacial radiology. Oral Radiol 2018; 35:3-10. [PMID: 30484206 DOI: 10.1007/s11282-018-0351-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 07/26/2018] [Indexed: 12/23/2022]
Abstract
Teachers of radiology often employ the use of classic signs to help learners identify the typical appearance of various pathologies. This article is a compendium of simply-described classic signs in oral and maxillofacial radiology, including their use in differential diagnoses.
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Affiliation(s)
- Galal Omami
- Department of Oral Health Practice, Division of Oral Medicine, Diagnosis and Radiology, University of Kentucky College of Dentistry, 800 Rose Street, Room MN-320, Lexington, KY, 40536-0297, USA.
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20
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Early Diagnosis: A Seeming Misfortune for Osteosarcoma of Mandible-Rare Case Report. Indian J Otolaryngol Head Neck Surg 2018; 71:748-751. [PMID: 31742056 DOI: 10.1007/s12070-018-1534-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 11/13/2018] [Indexed: 10/27/2022] Open
Abstract
Osteosarcoma is a mesenchymal malignant tumour of long bones; it is the second most common malignancy of bone after multiple myeloma but it rarely affects jaw, accounting only for 4-8% of all osteosarcomas (Baumhoer et al. in Oral Oncol 50(2):147-153, 2014). The rare occurrence of tumour makes it challenging to diagnose either by radiographic or histopathologic examination. Here we presented a rare case of chondroblastic variant of osteosarcoma of body of mandible in a 54 year old female.
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21
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Bouloux GF, Roser SM, Abramowicz S. Pediatric Tumors of the Temporomandibular Joint. Oral Maxillofac Surg Clin North Am 2018; 30:61-70. [PMID: 29153238 DOI: 10.1016/j.coms.2017.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The incidence of tumors and pseudotumors of the temporomandibular joint (TMJ) in the pediatric population is low. They are often challenging to recognize unless associated with signs and symptoms that may erroneously be interpreted as TMJ dysfunction. Tumors of the TMJ can be divided into 3 categories based on the nature and type of precursor cell involved in the tumor: benign tumors, malignant tumors, and pseudotumors. This article discusses the most common entities in these categories.
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Affiliation(s)
- Gary F Bouloux
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, 1365 Clifton Road, Atlanta, GA 30322, USA
| | - Steven M Roser
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, 1365 Clifton Road, Atlanta, GA 30322, USA; Section of Dentistry/Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, 1405 Clifton Road, Atlanta, GA 30322, USA
| | - Shelly Abramowicz
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, 1365 Clifton Road, Atlanta, GA 30322, USA; Section of Dentistry/Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, 1405 Clifton Road, Atlanta, GA 30322, USA.
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22
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Omami G. "Cookie-bite" lesion of the mandible. J Am Dent Assoc 2017; 148:530-534. [PMID: 28545920 DOI: 10.1016/j.adaj.2017.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/07/2017] [Accepted: 05/04/2017] [Indexed: 12/14/2022]
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23
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Tudor-Green B, Fonseca FP, Gomez RS, Brennan PA. Current update on the diagnosis and management of head and neck hard tissue sarcomas. J Oral Pathol Med 2017; 46:667-673. [DOI: 10.1111/jop.12573] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Ben Tudor-Green
- Department of Plastic and Reconstructive Surgery; Royal Devon & Exeter Hospital; Exeter UK
- Department of Oral and Maxillofacial Surgery; Queen Alexandra Hospital; Portsmouth UK
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Ricardo S. Gomez
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Peter A. Brennan
- Department of Oral and Maxillofacial Surgery; Queen Alexandra Hospital; Portsmouth UK
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24
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Li BB, Zhang JY, Gao Y. Chondroblastic osteosarcoma arising in the maxilla mimicking the radiographic and histological characteristics of cemento-osseous lesions: A case report. Mol Clin Oncol 2017; 6:733-736. [PMID: 28529749 DOI: 10.3892/mco.2017.1219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 02/10/2017] [Indexed: 01/25/2023] Open
Abstract
Osteosarcomas of the jaw are comparatively rare and represent only 2-10% of all osteosarcomas. We herein present a rare case of an osteosarcoma exhibiting the radiographic and histological characteristics of cemento-osseous lesions in the alveolar ridge of the maxilla. A 53-year-old male patient presented with the complaint of gradual swelling of the left maxilla over 4 years. Radiography revealed an ill-defined radioopaque mass, intimately associated with the apices of the involved teeth, without a periosteal reaction. Microscopically, a cementicle-like structure was identified in the alveolar bone. In addition, the lesion exhibited typical characteristics of chondroblastic osteosarcoma in the body of the maxilla. The tumor contained abundant osteoid and cartilage intimately associated with anaplastic tumor cells. The cartilage displayed malignant-appearing cells in lacunae, and there was crowding at the periphery of the lobule where the spindle cells formed sheets. The differential diagnosis included primary osteosarcoma, concurrent cemento-osseous dysplasia and osteosarcoma, or a secondary osteosarcoma based on a pre-existing cemento-osseous lesion. The presence of the cementicle-like structure in the alveolar bone and the involvement of the periodontal ligament and alveolar bone proper were unique in our case. The general invasive growth pattern and the abundance of the irregular tumor bone helped establish the diagnosis of primary osteosarcoma. This case may represent evidence of the pathogenesis of primary osteosarcoma in the jaw.
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Affiliation(s)
- Bin-Bin Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, P.R. China
| | - Jian-Yun Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, P.R. China
| | - Yan Gao
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, P.R. China
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25
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Rogozhin DV, Bulycheva IV, Konovalov DM, Talalaev AG, Roshchin VY, Ektova AP, Bogoroditsky YS, Strykov VA, Kazakova AN, Olshanskaya YV, Kachanov DY, Tereshchenko GV. [Classical osteosarcoma in children and adolescent]. Arkh Patol 2016; 77:68-74. [PMID: 27077157 DOI: 10.17116/patol201577568-74] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Classical osteosarcoma is one of the most common primary malignant bone tumors in children and adolescents. It more frequently occurs in the areas of the highest growth plate proliferation: limb long bones particularly in the distal femur (30%), proximal tibia (15%), and proximal humerus (15%). In the long bones, the tumor is located usually in the metaphysis (90%), less frequently in the diaphysis (9%), and very rarely in the epiphysis. This paper considers the clinical, radiological, and histological diagnosis, and prognosis in this pathology.
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Affiliation(s)
- D V Rogozhin
- Russian Children's Clinical Hospital; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | | | - D M Konovalov
- Russian Children's Clinical Hospital; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - A G Talalaev
- Russian Children's Clinical Hospital; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - V Yu Roshchin
- Russian Children's Clinical Hospital; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - A P Ektova
- Russian Children's Clinical Hospital; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | | | | | - A N Kazakova
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Yu V Olshanskaya
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - D Yu Kachanov
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - G V Tereshchenko
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
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26
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Gerrand C, Athanasou N, Brennan B, Grimer R, Judson I, Morland B, Peake D, Seddon B, Whelan J. UK guidelines for the management of bone sarcomas. Clin Sarcoma Res 2016; 6:7. [PMID: 27148438 PMCID: PMC4855334 DOI: 10.1186/s13569-016-0047-1] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 03/09/2016] [Indexed: 01/02/2023] Open
Abstract
This document is an update of the British Sarcoma Group guidelines published in 2010. The aim is to provide a reference standard for the clinical care of patients in the UK with bone sarcomas. Recent recommendations by the European Society of Medical Oncology, The National Comprehensive Cancer Network and The National Institute for Health and Care Excellence have been incorporated, and the literature since 2010 reviewed. The standards represent a consensus amongst British Sarcoma Group members in 2015. It is acknowledged that these guidelines will need further updates as care evolves. The key recommendations are that bone pain or a palpable mass should always lead to further investigation and that patients with clinico-radiological findings suggestive of a primary bone tumour at any site in the skeleton should be referred to a specialist centre and managed by a fully accredited bone sarcoma multidisciplinary team. Treatment recommendations are provided for the major tumour types and for localised, metastatic and recurrent disease. Follow up schedules are suggested.
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Affiliation(s)
- Craig Gerrand
- />Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, NE7 7DN UK
| | | | | | - Robert Grimer
- />Royal Orthopaedic Hospital, Birmingham, B31 2AP UK
| | | | - Bruce Morland
- />Birmingham Children’s Hospital, Birmingham, B4 6NH UK
| | - David Peake
- />Queen Elizabeth Hospital, Birmingham, B15 2TH UK
| | | | | | - On behalf of the British Sarcoma Group
- />Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, NE7 7DN UK
- />Nuffield Orthopaedic Centre, Oxford, OX3 7LD UK
- />Royal Manchester Children’s Hospital, Manchester, M13 9WL UK
- />Royal Orthopaedic Hospital, Birmingham, B31 2AP UK
- />The Royal Marsden, Sutton, SM2 5PT UK
- />Birmingham Children’s Hospital, Birmingham, B4 6NH UK
- />Queen Elizabeth Hospital, Birmingham, B15 2TH UK
- />University College Hospital, London, NW1 2PG UK
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27
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Fang Z, Jin S, Zhang C, Wang L, He Y. Misdiagnosis of osteosarcoma as cementoblastoma from an atypical mandibular swelling: A case report. Oncol Lett 2016; 11:3761-3765. [PMID: 27313689 DOI: 10.3892/ol.2016.4433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 01/12/2016] [Indexed: 11/05/2022] Open
Abstract
Cementoblastoma is a form of benign odontogenic tumor, with the preferred treatment consisting of tooth extraction and follow-up examinations, while in certain cases, follow-up examinations without surgery are performed. Osteosarcoma of the jaw is a rare, malignant, mesenchymal tumor, associated with a high mortality rate and low incidence of metastasis. Cementoblastoma and osteosarcoma of the jaw are dissimilar in terms of their histological type and prognosis; however, there are a number of covert associations between them. The present study describes the case of a 20-year-old female with an unusual swelling in the left mandible that had been present for 2 years. The patient was initially clinically diagnosed with cementoblastoma; however, following pathological examination, a diagnosis of osteosarcoma was confirmed. A total mandibulectomy was performed on the left mandible, with a fibular osteomyocutaneous flap used for reconstruction. At the 6-month post-operative examination, the patient demonstrated normal occlusion and oral commissure, and no recurrence or metastasis was observed over 2 years of follow-up.
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Affiliation(s)
- Zao Fang
- Department of Oral Maxillofacial Head and Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, P.R. China
| | - Shufang Jin
- Department of Oral Maxillofacial Head and Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, P.R. China
| | - Chenping Zhang
- Department of Oral Maxillofacial Head and Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, P.R. China
| | - Lizhen Wang
- Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, P.R. China
| | - Yue He
- Department of Oral Maxillofacial Head and Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, P.R. China
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Spontaneous osteosarcoma in craniomaxillofacial fibrous dysplasia: clinical and computed tomographic features in 8 cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:e24-31. [DOI: 10.1016/j.oooo.2014.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 02/26/2014] [Accepted: 03/10/2014] [Indexed: 12/29/2022]
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29
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Kadlub N, Kreindel T, Belle Mbou V, Coudert A, Ansari E, Descroix V, Ruhin-Poncet B, Coulomb L'Hermine A, Berdal A, Vazquez MP, Ducou Lepointe H, Picard A. Specificity of paediatric jawbone lesions: Tumours and pseudotumours. J Craniomaxillofac Surg 2014; 42:125-31. [DOI: 10.1016/j.jcms.2013.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 03/20/2013] [Accepted: 03/21/2013] [Indexed: 12/12/2022] Open
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30
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Osteosarcomas of the jaws differ from their peripheral counterparts and require a distinct treatment approach. Experiences from the DOESAK Registry. Oral Oncol 2013; 50:147-53. [PMID: 24246156 DOI: 10.1016/j.oraloncology.2013.10.017] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 10/23/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We aim to emphasize crucial differences between osteosarcomas of the jaws (OSj) and those of the peripheral skeleton (OSp) and to question current therapeutic concepts in presenting a comprehensive study on 214 patients. BACKGROUND OSj account for only 6% of all osteosarcomas (OS) but seem to represent a clinically and prognostically distinct subgroup. Due to the limited experience with this rare disease it is still a matter of debate if (neo-)adjuvant chemotherapy can improve the outcome of patients like in OSp or if OSj patients can be cured by surgical treatment only. METHODS 214 well characterized OSj patients with long-term follow up are presented and the influence of clinico-pathological parameters affecting the prognosis of patients is discussed. RESULTS The OSj patients in our series showed metastatic spread far less frequently (17.6% of cases) and later in the course of the disease (26months after diagnosis on average) compared to OSp. Consequently, complete resection of the tumors resulted in an excellent long-term survival (83.2% after 10years). Neoadjuvant or adjuvant treatment applied in a smaller subset of patients, furthermore, failed to show any additional favorable effect. CONCLUSION Whereas OSp is regarded as systemic disease at the time of diagnosis in which >90% of patients develop lung metastases without multimodality treatment, the vast majority of OSj patients seem to be curable by complete resection only. Based on the findings presented here, multimodality treatment should be critically scrutinized in OSj patients.
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