Osteosarcoma of Left Maxillary sinus : A case report
Osteosarcoma is one of the most frequently occurring malignant bone tumor except for multiple myeloma. It can occur in any bone, usually in the extremities of the long bones. Osteosarcoma of the jaw is a rare malignant neoplasm which constitutes 5% to 6.7 % of all the cases of skeletal osteosarcomas. We report a case of osteosarcoma of Left maxillary sinus – 28 years old female – which was excised under General anesthesia
Case Presentation
Age/Sex: 28/F
C/C: Swelling in the upper left back region of the jaw
PMH:DM/HBP/TBc/hepatitis: -/-/-/-
Op hx.: Aug/2006, Fibroadenoma of both breat excision(Department of General Surgery)
Dec/2010, Mixoid liposarcoma of abdominal area excision(Department of General
Surgery)
PDH: N/S
Allergy: N/S
PI: Extraoral Findings
1. Slightly swelling of Left facial area.
Intraoral Findings
1. A swelling in ther upper left back region of the jaw.
Plan for Diagnosis
1. Panoramic Radiography (Fig 1) & Medical CT (Fig 2)
2. Tumor resection under General Anesthesia(Fig 3)
Dx: Osteosarcoma of Left. maxillary sinus, sclerotic type(Fig 4)
Tx: Mar.9th/2012 Excision ofMass(Left maxillary sinus) under G/A.(Dx:Osteosarcoma)
Mar.12th/2012 PET CT taking(Fig 5)
May.15th/2012 Partial maxillectomy under G/A(Fig 6)
July.27th/2012 Chemotherapy.
Discussion
Osteosarcoma is one of the most frequently occurring malignant bone tumor except for multiple myeloma. It can occur in any bone, usually in the extremities of the long bones. Osteosarcoma of the jaw is a rare malignant neoplasm which constitutes 5% to 6.7 % of all the cases of skeletal osteosarcomas. In initial stage, asymptomatic swelling can be oserved, and pain, tooth mobility, paresthesia, gingival bleeding can be occurred by tumor growth. The most effective treatment protocol is radical surgery and five-year survival rate that reported in previous literature is 50% in maxilla and 70% in mandible.28 years old female patient, who has a swelling on Left maxilla(vestibule of Retromolar area), visited our department. She underwent Resection of abdominal liposarcoma 2 years ago. She was initially diagnosed by Radiopaque mass of Left maxillary sinus by Computeraized tomography. Under general anesthesia, Mass was excised and sent for biopsy. Biopsy report showed Osteosarcoma,sclerotic type. Under the diagnosis, She underwent partial maxillectomy with a safety margin of normal bone. The surgical wound was then managed by primary closure. Patient is kept on follow up after surgery since last six months during which chest radiograph; CT scan and bone scan were advised to keep a check on recurrence of the lesion. All the reports were normal