High-grade chondroblastic and fibroblastic osteosarcoma of the upper iaw

Osteosarcomas (OS) are extremely uncommon in maxillofacial region (6%-10% of all sarcomas). Jaw lesions are diagnosed on average two decades later than sarcomas of long bone, with a peak incidence between 20 and 40 years. Head and neck OS (HNOS) are associated with a lower metastatic rate than long bone OS, and they have a better 5-year survival rate, ranging between 27% and 84%. Approximately 80% of HNOS originate from soft tissues, while 20% arise from bone. The majority of OS were classifi ed as osteoblastic HNOS (77.0%), followed by chondroblastic (15.8%) and fi broblastic (3.4%). Patients older than 60 years were more likely to be diagnosed with other histologic types compared with patients 60 years or younger. The authors describe a rare case of Stage II high-grade mixed chondroblastic and fi broblastic osteosarcoma of the upper jaw diagnosed in a subject older than 60 years. CT i.e., total body scintigraphy, radiograph of chest, and epathic ultrasonography have been executed to staging (T3N0M0). The size of the tumor >6 cm, histopathological fi ndings, and patient older than 60 years, made necessary a multimodality therapy. Surgery (right subtotal maxillectomy with closure of surgical area by local sliding and advanced cheek fl ap) and adjuvant radiotherapy (for overall 6500 Gy) were the defi nitive treatment. Follow-up at 2 years shows no local recurrence and the patient is disease free.