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A digital manual for the early diagnosis of oral neoplasia

Osteosarcoma  Search in Medline for Osteosarcoma



Osteosarcomas of the oral cavity are rare and are usually seen in adolescents and young adults. The mandible is more commonly affected than maxilla. Osteosarcoma appears as painless swelling in the initial phase; later, in advanced cases, pain, paraesthesia and loosening of the teeth may be the presenting symptoms. The radiographic appearance of osteogenic sarcoma is widely variable. On a plain radiograph, the tumour is usually lytic but may be sclerotic or mixed. Soft tissue extension is seen in over half of the lesions. Computed tomogram is better in demonstrating matrix mineralization and soft tissue extension.

Osteosarcomas of the oral cavity are locally aggressive, and the metastatic potential of these tumours are less compared to osteosarcomas in long bones. Complete surgical excision of the tumour is the mainstay of treatment in patients with osteosarcomas of the oral cavity. Negative surgical margins appear to be only significant predictor of overall and disease-specific survival. Patel SG, Meyers P, Huvos AG, Wolden S, Singh B, Shaha AR, Boyle JO, Pfister D, Shah JP, Kraus DH. Improved outcomes in patients with osteogenic sarcoma of the head and neck. Cancer. 2002 Oct 1;95(7):1495-503.. The role of post-operative radiotherapy and adjuvant chemotherapy are not clear.

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Figure 1A: Osteosarcoma in a 22–year-old man. Note the extensive swelling arising from right maxilla extending to the orbit. Histopathological examination revealed osteosarcoma. Figure 1B: Intraoral picture of the same patient. Note the diffuse swelling (arrow) involving the right buccal sulcus and maxillary tuberosity.
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