Osteosarcoma of the jaws: a 30-year retrospective review.
OBJECTIVE
This article reviews osteosarcomas of the jaws referred to the Department of Oral Pathology, Eastman Dental Institute, for histologic diagnosis during the 30 years from 1968 to 1998, to compare the clinical behavior of the tumors, to assess how they differ from the reported characteristics of tumors from other sites, and to report on observations of clinical and diagnostic significance.


METHODS
The clinical, radiographic, and histopathologic records of 25 patients were obtained for retrospective review. Supportive and follow-up clinical and histopathologic material was obtained from the referring clinicians.


RESULTS
The mean age of presentation of the primary lesions was 36. 9 years (range, 10-87 years) with a slight female predilection. The most common presenting features were swelling, pain, ulceration, or a neurologic deficit. The radiographic appearance of the lesions was mixed with areas of radiopacity and radiolucency. Histologically, the lesions ranged from those dominated by immature bony trabeculae separated by a cytologically bland stroma to high-grade, cellular lesions with regions of marked atypia and mitotic activity. Most had areas of chondroid formation, in addition to neoplastic osteoid. The main complication was local recurrence. Metastasis was rare and occurred as a solitary process or at a late stage in the disease progression. This was in contrast to lesions metastatic to the jaws, which were higher grade in appearance and had metastasized widely, early in the disease process. Primary osteosarcoma occurring in patients with a history of radiotherapy was typically more aggressive.


CONCLUSIONS
Primary osteosarcomas of the jaws are a group of lesions distinct from those occurring in the long bones. Osteosarcomas of the jaw arising in a former radiation field may be a discrete group of lesions with a more aggressive behavior pattern.
Bennett
J H
JH
Department of Oral Pathology, Eastman Dental Institute, University College London, UK. J.Bennett@eastman.ucl.ac.uk
Thomas
G
G
Evans
A W
AW
Speight
P M
PM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007573:Jaw Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000473:pathology*; D012189:Retrospective Studies