Gnathic osteosarcoma is a subtype of osteosarcoma that primarily affects the mandible (horizontal ramus) and maxilla (alveolar ridge, sinus floor, and palate).
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Epidemiology
- represents ~6% of osteosarcomas 3
- 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:
- osteomyelitis
- osteoma: less aggressive appearance
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