Presentation
Young male presented with swelling in right parotid region
Patient Data
A heteogeneously enhancing soft tissue tumor mass originating from surface of outer cortex of right ramus of mandible. Lesion extended from anterior to posterior border of ramus anterio-posteriorly. Tumor involved coronoid process, condylar process and ramus of mandible causing surface erosions. The involved bone shows abnormal spiculated periosteal elevation which is radiating outwards. The soft tissue component shows fine calcifications. The mass is abutting and displaceing parotid gland laterally and pterygoid muscles medially without visible invasion of these structures. Imaging features are suggestive of osteosarcoma of mandible.
Case Discussion
Mandibular osteosarcomas are rare but common primary bone tumor of the jaw. It can occur in typical osteoblastic fashion or can variably present as pure osteolytic type which can be difficult to be diagnosed on imaging. Imaging differentials include chondrosarcoma (which is far more rare than the osteosarcoma and less osteoblastic), which is difficult to be distinguished radiologically or even histopathologically from the osteosarcoma. Another benign differential diagnosis includes cementoblastoma, but the hard-tissue component, showing external resorption continues with the root of the involved tooth is the hallmark of cementoblastomas.
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