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].