Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2011 Jul;1(2):176-80.
doi: 10.4103/2231-0746.92790.

High-grade chondroblastic and fibroblastic osteosarcoma of the upper jaw

Tommaso Cutilli  1 , Secondo Scarsella, Desiderio Di Fabio, Antonio Oliva, Pasqualino Cargini
Affiliations
Case Reports

High-grade chondroblastic and fibroblastic osteosarcoma of the upper jaw

Tommaso Cutilli et al. Ann Maxillofac Surg. 2011 Jul.

Abstract

Osteosarcomas (OS) are extremely uncommon in maxillofacial region (6%-10% of all sarcomas). Jaw lesions are diagnosed on average two decades later than sarcomas of long bone, with a peak incidence between 20 and 40 years. Head and neck OS (HNOS) are associated with a lower metastatic rate than long bone OS, and they have a better 5-year survival rate, ranging between 27% and 84%. Approximately 80% of HNOS originate from soft tissues, while 20% arise from bone. The majority of OS were classified as osteoblastic HNOS (77.0%), followed by chondroblastic (15.8%) and fibroblastic (3.4%). Patients older than 60 years were more likely to be diagnosed with other histologic types compared with patients 60 years or younger. The authors describe a rare case of Stage II high-grade mixed chondroblastic and fibroblastic osteosarcoma of the upper jaw diagnosed in a subject older than 60 years. CT i.e., total body scintigraphy, radiograph of chest, and epathic ultrasonography have been executed to staging (T3N0M0). The size of the tumor >6 cm, histopathological findings, and patient older than 60 years, made necessary a multimodality therapy. Surgery (right subtotal maxillectomy with closure of surgical area by local sliding and advanced cheek flap) and adjuvant radiotherapy (for overall 6500 Gy) were the definitive treatment. Follow-up at 2 years shows no local recurrence and the patient is disease free.

Keywords: Maxilla; osteosarcoma; surgery.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a, b) Clinical and radiographic aspect of the tumor
Figure 2
Figure 2
(a) CT axial scan for loco-regional staging of the the tumor. A lymph-node is present in 1b level (white arrow) (b) Total body scintigraphy shows a pathological tracer in the right maxilla (black arrow)
Figure 3
Figure 3
(a) Weber-Fergusson approach. Intraoperative aspects show the tumoral mass (b) and subtotal maxillectomy (c). (d) Final view
Figure 4
Figure 4
Tumor size is greater than 6 cm
Figure 5
Figure 5
Histopathological pattern of the tumor: (a) osteoblastic proliferation (H & E, ×4); (b) High-power magnification (H & E, ×10). (c) Chondroblastic proliferation H & E, ×4; (d) High-power magnification (H & E, ×10); (e) Fibroblastic proliferation (H & E, ×4); (f) Immunohistochemical pattern (positivity for S-100 protein)
Figure 6
Figure 6
Follow-up at 2 years [(a) CT scan, (b) total body scintigraphy, (c) panoramic radiograph, and (d) clinical finding]
See this image and copyright information in PMC

References

    1. Kassir RR, Rassekh CH, Kinsella JB, Segas J, Carrau RL, Hokanson JA. Osteosarcoma of the head and neck: Meta-analysis of nonrandomized studies. Laryngoscope. 1997;107:56–61. - PubMed
    1. Fernandes R, Nikitakis NG, Pazoki A, Ord RA. Osteogenic sarcoma of the jaw: A 10-year experience. J Oral Maxillofac Surg. 2007;65:1286–91. - PubMed
    1. Luna-Ortiz K, Villavicencio-Valencia V, Carmona-Luna T, Pasche P, Mosqueda-Taylor A. Osteogenic sarcoma of the maxillary region in a Mexican mestizo population. J Craniofac Surg. 2010;21:1709. - PubMed
    1. Granowski-LeCornu M, Chuang SK, Kaban LB, August M. Osteosarcoma of the Jaws: Factors influencing prognosis. J Oral Maxillofac Surg. 2011;69:2368–75. - PubMed
    1. Smith RB, Apostolakis LW, Karnell LH, Koch BB, Robinson RA, Zhen W, et al. National Cancer Data Base report on osteosarcoma of the head and neck. Cancer. 2003;98:1670–80. - PubMed

Publication types