Osteosarcoma of the jaw - The Chaim Sheba Medical Center experience

Objective. The purpose of this article is to present 14 cases of osteosarco ma of the jaw treated at our medical center from 1989 to 1998. These cases are discussed in the light of a comprehensive review of 774 cases reported in the English literature over the past 3 decades. Differences between oste osarcoma of the jaws and osteosarcoma of the long bones are examined. Subjects and Methods. The patients ranged in age from 8 to 78 years, the me an age being 33 years. Each patient had a histopathologically established d iagnosis of osteosarcoma of the jaw. Records were reviewed for epidemiologi c data, treatment modalities, and survival. Results. Oi the 14 patients, 6 (42%) had tumors in the mandible and 8 (58%) had rumors in the maxilla. Of the mandibular tumors, 5 occurred in the bod y of the mandible; all maxillary tumors originated in the alveolar ridge an d involved the maxillary sinus. The chief complaint was an intraoral or ext raoral painless swelling. Histopathologic types included chondroblastic, os teoblastic, fibroblastic, and malignant fibrous histiocytoma-like. Patholog ic grade was determined to be high (3 or 4) in 13 cases and low (1) in only 1 mandibular case. All patients underwent surgical resection and immediate reconstruction. Adjuvant therapy included postoperative radiation (5 patie nts), postoperative chemotherapy (2 patients), and preoperative chemotherap y and postoperative radiation (1 patient). Conclusions, The results of the present study support the literature indica ting that osteosarcoma of the jaw differs from osteosarcoma or the long bon es in its biological behavior even though they have the same histologic app earance. Because of differences in tumor characteristics, the introduction of chemotherapy did not dramatically alter the prognosis of osteosarcoma of the jaw. Early diagnosis and radical surgery are the keys to high survival rates.