Gnathic osteosarcoma

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Gnathic osteosarcoma is a subtype of osteosarcoma that primarily affects the mandible (horizontal ramus) and maxilla (alveolar ridge, sinus floor, and palate).

Epidemiology

  • represents ~6% of osteosarcomas  
  • 60% in males
  • has an older onset (~30 years) and a peak incidence: 30-40 years

Clinical presentation

  • gnawing pain and swelling in the mandible and maxilla
  • sessile gingival swelling

Radiographic features

  • 60% are osteoblastic
  • 34% are fibroblastic
  • <10% chondroblastic
Orthopantograph
CT

Described features include:

  • cortical involvement
  • soft-tissue extension
  • intramedullary bone extension
  • matrix calcification

Treatment and prognosis

Treatment plan generally includes preoperative chemotherapy followed by surgical excision and postoperative chemotherapy.

Osteosarcoma of the mandible has a more favorable prognosis than that of the maxilla.

History and etymology

The term gnathic is from the Greek word gnathos "γνάθος" meaning jaw.

Differential diagnosis

In general, differential diagnoses include:

See also