Osteosarcoma generally has a poor prognosis. Osteosarcoma of the mandible i
s rare and may have a less aggressive course. Three patients with osteosarc
oma of the mandible were treated during the past 19 years at National Taiwa
n University Hospital. All were women, with an average a,ae of 49 years. Th
e patients were treated with radical excision of the tumor, with either pre
- or postoperative radiotherapy. None of the patients received chemotherapy
. Reconstruction with iliac osteocutaneous free flap, fibular osteoseptocut
aneous free flap, or Leibinger reconstruction plate was performed to repair
the facial defects resulting from tumor resection or radiation-induced nec
rosis. The three patients were alive and without evidence of recurrence at
the time of writing, with followup periods ranging from 7 to 18 years. All
had acceptable facial contour and satisfactory oromandibular function after
reconstruction. These results support the effectiveness of wide resection
with radiotherapy for treatment of mandibular osteosarcoma. With the availa
bility of microsurgical reconstruction and biocompatible reconstruction pla
tes, we advocate extensive ablation of this tumor. Long-term survival, good
functional recovery, and acceptable facial contour can be expected.