Osteosarcoma of the Jaws: Report of 3 Cases with Emphasis on the Early Clinical and Radiographic Signs

Abstract Osteosarcoma is the most common primary malignancy of the jaws and is treated by radical surgical resection. Early detection is crucial since removing the lesion with clean margins contributes most to outcome. We present three cases of osteosarcoma occurring in the interradicular region of the mandible, two of which were thought to represent non-malignant processes upon initial presentation. All three demonstrated early but significant clinical and radiographic features indicative of the malignant disease process. Radiographically, all of these cases had in common unilateral periodontal ligament (PDL) space widening, displacement of teeth, and growth of the crestal bone. Clinically, all three cases presented with a painless intraoral swelling. Case 1: A 20 year old African American male presented with a swelling and loose teeth of 1.5 months duration. Histopathological diagnosis of osteoblastic osteosarcoma, high grade was made. Case 2: A 75 year old Caucasian male presented with a 2 × 2 cm expansile lesion of two months duration. Histopathological diagnosis of chondroblastic osteosarcoma was made. Case 3: A 63 year old Caucasian female presented with a 5-6 mm lesion for at least 1 month duration. Histopathological diagnosis of chondroblastic osteosarcoma was made. All three cases were treated with wide surgical resection.