Osteosarcoma of the maxillofacial bones in Kenyans

doi:10.1016/S1010-5182(98)80047-4

Journal of Cranio-Maxillofacial Surgery

Volume 26, Issue 2, April 1998, Pages 98-101

https://doi.org/10.1016/S1010-5182(98)80047-4 Get rights and content

Summary

Osteosarcoma (OS) is a highly malignant tumour and is the most common primary neoplasm of bone; although rare, especially in the maxillofacial skeleton. This article presents 14 Kenyan cases of OS of the maxillofacial bones seen between January 1991 and July 1997: 11 in the mandible, two in the maxilla and one in the right zygomatic arch. Patients ranged in age from one week to 50 years (Mean = 29.7), with an equal gender distribution. While pain and rapid swelling were the commonest clinical features, the radiographic and histopathological characteristics were as varied as has been described elsewhere. Generally, effective management of most of the cases was poor due to late presentation for treatment.

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Cited by (11)

Clinical, therapeutic and prognostic features of osteosarcoma of the jaws - Experience of 36 cases
2012, Journal of Cranio-Maxillofacial Surgery
Citation Excerpt :
In differential diagnosis, for example simple infections, and diseases such as fibrous dysplasia and osteomyelitis must be taken into consideration (Granowski-LeCornu et al., 2011; Petrikowski et al., 1995). Radiological and, most important, a comprehensive histopathological assessment is necessary (Chindia et al., 1998; Werner et al., 1996). OSJ have a high tendency towards local relapse (mandible 39–70%; maxilla 15–53%)(Mark et al., 1991; Wilcox et al., 1973).
Osteosarcoma of the jaws (OSJ) differs from osteosarcoma of other skeletal regions due to later development, a high mortality associated with the local disease, fewer incidences of metastases and its extreme rarity. In regard to clinical and pathological parameters as well as therapeutic approaches and prognosis, OSJ has not been specifically examined to date. In order to achieve a better understanding of this special malignancy, an evaluation of incidence, treatment and prognosis of patients with OSJ in our department over the past 38 years was conducted.
A retrospective analysis of patients with OSJ between 1972 and 2010 was performed. Information regarding patient characteristics, site of the lesion, main presenting symptoms, latency of initial diagnosis, treatment, histology, local recurrence, development of metastatic disease, duration of follow up and survival was obtained. The data were compared to the literature.
Thirty-six patients (2–81 years, mean: 33.9, standard deviation: 21.3) were diagnosed and treated for OSJ (maxillar:mandibular nearly 1:2). Initial symptoms were local swelling (81%) and pain (47%). The latency period between fist symptoms and clinical presentation was 3.7 months (1–24). A radical resection alone was conducted in 15 patients. In nine patients, resection and radiotherapy was used. Resection with chemotherapy was the treatment of choice in seven patients. Five patients received a triple combination of resection, chemo- and radiation therapy. The osteoblastic subtype of osteosarcoma was most frequent (42%). In 15 cases (42%) local recurrences, in two cases (5%) metastasis were seen. Of these patients, 13 died within the observation period. One other patient (3%) died as a result of progressive pulmonary metastasis. A mean total survival rate of 61% could be seen whereas the highest survival rate (80%) was found in patients who were treated with neoadjuvant chemotherapy, radical resection and adjuvant radiation. Positive prognostic factors were a younger age and tumour-free resection margins.
OSJ is a highly lethal tumour entity. According to the data at hand, therapy should possibly include chemotherapy, radical resection and irradiation. Nevertheless, due to the rarity of OSJ, information remains limited and the treatment of choice should be within the focus of clinical multi-centre studies.
Clinical features and types of paediatric orofacial malignant neoplasms at two hospitals in Nairobi, Kenya
2012, Journal of Cranio-Maxillofacial Surgery
Citation Excerpt :
In the head and neck region OS represents about 7% of all neoplasms involving mainly the jaws (Wanebo, 1992). Chindia et al. (1998) in a report of 14 cases of OS of the maxillofacial bones among Kenyans found 3 cases in patients aged less than 15 years. All the 3 cases were in the mandible and presented with pain, swelling and ulceration.
To evaluate the clinical features and histopathological types of orofacial malignant neoplasms in children.
The study involved patients aged 15 years and below diagnosed with malignancy at two main referral hospitals in Kenya during the period from July, 2008 to December, 2008. A questionnaire and clinical examination chart were used to document data. Data analysis was done using SPSS 12.0 programme.
65 children (44 males, 21 females) with ages ranging from 0.25 to 14 years were evaluated. The main complaints were swelling 61 (94%) and visual disturbance 29 (45%). The mean duration of symptoms was 0.17–36 months. The commonest signs were leucocoria (white reflection from the retina) 23 (35%), proptosis 19 (29%) and loss of vision 15 (23%). The commonest sites were orbit 30 (46%) and maxilla 11 (17%). Most neoplasms were retinoblastoma 26 (40%), followed by 14 (21%) cases of Burkitt’s lymphoma (BL) and occurred in patients under 5 years of age (40 cases) followed by 19 cases in children aged 5–10 years.
Overall, malignancies were more common in males than females with most having been diagnosed in children aged less than 10 years. Retinoblastoma and BL were the most common neoplasms.
Osteosarcoma of the jaw bones
2001, Oral Oncology
Citation Excerpt :
Among the thirty cases presented recently by August et al. [6], the age range was 4–84 years. Notably, Chindia et al. [11] presented a 1-week-old female patient in their series of 14 cases of OS. Thus, this disease may manifest at any age.
Currently, it has been established that osteosarcoma (OS) of bone is not a stereotyped disease, and several varieties have been identified by clinical findings, radiographic and histopathologic appearances. Generally, it is the most common primary malignant bone neoplasm that accounts for at least 30% of all primary tumours of bone. In the jaw bones, OS accounts for about 4% of all the primary malignant neoplasms. In the general skeleton, the highest incidence is observed in the second decade of life; the neoplasm is said to be unusual before the age of 5 years and very rare after age 50 years. The aetiology and precise pathogenesis of this disease remain unknown. A diagnosis of clinically and radiologically suspicious OS requires meticulous histologic examination. However, histologic diagnosis may also be difficult since the different varieties of OS may have different morphological patterns in different sample sites. Currently, the two therapeutic modalities used in the primary treatment of OS include radical surgery and cytotoxic chemotherapy. In the general skeleton, the use of surgery alone results in a 90% rate of recurrence of OS. Notably, the advent of adjuvant and neoadjuvant cytotoxic chemotherapy as an adjunct to radical surgery has greatly improved the prognosis of many cases of OS of the jaw bones.
Fibrous dysplasia of the Maxilla: Diagnostic reliability of the study image. Literature review
2013, Journal of Neurological Surgery, Part B: Skull Base
Osteosarcoma of the jaws: A review of literature and a case report on synchronous multicentric osteosarcomas
2012, World Journal of Surgical Oncology
Clinico-histopathologic types of maxillofacial malignancies with emphasis on sarcomas: A 10-year review
2011, East African Medical Journal

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Osteosarcoma of the maxillofacial bones in Kenyans

Summary

J. Oral Maxillofac. Surg.

Am. J. Surg.

Br. J. Oral Maxillofac. Surg.

Am. J. Surg.