Discussion
We report a case of giant mandibular osteosarcoma in a 52-year-old woman
without risk factors for malignant neoplasia. We were able to perform a
complete resection despite the impossibility of reconstruction due to
the size of the tumor.
Pardhe ND and his team reported a case of aggressive and fatal
mandibular giant osteosarcoma in a 23-year-old man [4]. They
concluded that if it had been diagnosed earlier, it would have added a
few precious years to the patient’s life.
The exact cause of osteosarcoma remains unknown, possible risk factors
have been identified: rapid bone growth, genetic predisposition, benign
bone lesions such as Paget’s disease and fibrous dysplasia, and
environmental factors such as ionizing radiation [5].
In contrast to long bone, osteosarcoma of the mandible occurs at an
older age at presentation, longer median survival, more frequent local
recurrence, lower incidence of distant metastases, and the possibility
of earlier detection due to its location in the face [6].
The treatment of choice for osteosarcoma of the jaw is adequate surgical
resection. [7, 8]. Wide radical resection should be done with
margins of 1.5 to 2 cm. In the mandible, hemimandibulectomy is usually
preferred. Maxillectomy is difficult because of the involvement of
adjacent structures such as the maxillary sinus, pterygopalatine fossa
and orbital fossa [9].
Radiotherapy and/or chemotherapy are recommended in addition to complete
surgery or alone as palliative treatment in incomplete resection and
more advanced cases [10].