Document Detail


The spectrum of gnathic osteosarcoma: caveats for the clinician and the pathologist.
MedLine Citation:
PMID:  21046296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Seven expansile jaw lesions in patients ranging from 7 to 63 years are presented to illustrate diagnostic and management issues pertaining to cases ultimately proven to be gnathic osteosarcoma (GO). Six of the cases in our series were low-grade osteoblastic and one high-grade chondroblastic. None of our cases exhibited the characteristic "sunburst" radiopaque appearance described for GO. All of our cases displayed cortical expansion and one showed development of diastema. Two occurred in the maxilla and five in the mandible. Two of the patients with mandibular lesions presented initially with pain; all other patients were asymptomatic. Lack of pain resulted in a delay in diagnosis due to postponement of consultation or biopsy. Two cases underwent initial shallow non-representative biopsies, requiring a second biopsy for definitive diagnosis, further delaying treatment. Those biopsies were initially interpreted as pyogenic granuloma and peripheral ossifying fibroma, respectively. GO should always be considered in the differential diagnosis of expansile jaw lesions. Bone biopsies of lesions exhibiting pain and expansion of cortical plates should include medullary bone in order to minimize sampling error. In addition, all rapidly growing or painful exophytic bone lesions, and presumed soft tissue lesions that may involve underlying bone, should be examined histopathologically, and receive clinical and radiographic follow-up until complete resolution or healing is evident, regardless of the diagnosis. Based on the positive outcomes of the patients in our series, the prognosis of GO appears to be relatively favorable when compared to other sarcomas and osteosarcomas of long bones.
Authors:
Ricardo J Padilla; Valerie A Murrah
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-11-03
Journal Detail:
Title:  Head and neck pathology     Volume:  5     ISSN:  1936-0568     ISO Abbreviation:  Head Neck Pathol     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-11     Completed Date:  2011-07-12     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  101304010     Medline TA:  Head Neck Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  92-9     Citation Subset:  IM    
Affiliation:
Division of Oral and Maxillofacial Pathology, Department of Diagnostic Sciences, University of North Carolina, Chapel Hill, NC, USA. padilla@dentistry.unc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Child
Female
Humans
Jaw Neoplasms / pathology*
Male
Middle Aged
Osteosarcoma / pathology*
Comments/Corrections

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