Mandibular osteogenic sarcoma (OS) is a very rare entity in childhood. Adeq
uate surgical rejection with a wide margin of normal tissue is the mainstay
of treatment of this site, while the role of adjuvant chemotherapy remains
uncertain. A case is presented of a 15 1/2-year-old male with a huge OS of
the mandible. The boy underwent surgical resection of the mandible with im
mediate fibula free flap reconstruction and is alive and free of disease 6
1/2 years following unitial diagnosis. This case suggests that immediate bo
ne reconstitution with vascularized grafts have good functional and morphol
ogical results for osteosarcoma of the lower jaw.