Osteosarcoma of the Jaw Bones: A Clinicopathologic Study of 44 Cases
Y Nakashima, E Konishi, Y Iwasa. Kyoto University Hospital, Kyoto, Japan; Kyoto Prefectural Medical School, Kyoto, Japan; Osaka City University School of Medicine, Osaka, Japan
Background: Osteosarcoma of the jaw bones has been considered to show clinicopathologically distinctive features, namely, generally affecting older patients, frequently showing low grade histology with predominance of chondroblastic type, and generally better prognosis.
Design: Forty four cases of osteosarcoma of the jaw bones were retrieved from the surgical pathology file. Clinical and roentgenologic findings, operational charts, description of the gross materials and follow up information were reviewed for each case. H & E stained histologic sections were available for all tumors.
Results: Of the 44 patients with osteosarcoma of the jaw bones, there were 3 cases (maxilla of a 18-year-old female, mandible in a 32-year-old female, maxilla in a 59-year-old female) of postradiation osteosarcoma, and 3 cases (maxilla in a 49-year-old female, maxilla in a 61-year-old male, mandible in a 37-year-old female with Albright syndrome) of osteosarcoma secondary to fibrous dysplasia. Residual 38 cases of the primary osteosarcoma of the jaw bones showed the age distribution from 10 to 82 (average 44.89) years, included 20 females and 18 males with 29 mandibular (18 in the body, 2 in the angle, and 9 in the ascending ramus) and 9 maxillary (3 in the antrum, 5 in the alveolar ridge, and 1 in the palate) lesions. Roentgenologically, the lesion was generally an ill-defined area suggesting malignancy, with lytic and/or sclerotic changes. Mandibular lesions frequently showed periosteal reaction including spicules. Predominant histologic features were osteoblastic in 13 tumors, chondroblastic in 9 tumors, and fibroblastic in 16 tumors. These 3 histologic types, however, frequently coexisted even in the same histologic specimen of a tumor. Fifteen tumors are low grade (grade 1 in 1 tumor, grade 2 in 14 tumors) and 23 were high grade (grade 3 in 19 tumors, grade 4 in 4 tumors). All patients underwent resection of the tumor, and local recurence of the tumor and metastasis to the lung were main complication.
Conclusions: (1) Osteosarcoma of the jaw bones can show a wide histologic spectrum seen in conventional osteosarcoma in the long bones, with high incidence of high grade (grade 3 + grade 4) tumors than low grade (grade 1 + grae 2) tumors. (2) Although incidence of chondroblastic type is higher than in other locations, high grade osteoblastic and fibroblastic pattern is more common in osteosarcoma affecting the jaw bones.
Category: Bone & Soft Tissue
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 10, Tuesday Morning