Osteosarcomas and chondrosarcomas of the jaws: Clinicopathological study of 17 cases and review of the literature
Vayia BOUTLA, Georgios KAMPEROS, Evangelia PIPERI, Nikolaos NIKITAKIS, Konstantinos TOSIOS, Alexandra SKLAVOUNOU
Department of Oral Medicine and Pathology, School of Dentistry, National and Kapodistrian University of Athens, Greece (Head: Professor A. Sklavounou)
Hellenic Archives of Oral & Maxillofacial Surgery (2017) 3, 115-128
SUMMARY: Οsteosarcomas and chondrosarcomas of the jaws are extremely rare malignant neoplasms, representing only a small number of the total sarcomas of the skeleton.
Materials and methods: The retrospective study of the histopathology archives of the Department of Oral Medicine and Pathology during the period 1970-2016 re- vealed 12 osteosarcomas and 5 chondrosarcomas of the jaws, in a total of 33,542 biopsies of the corresponding period. Their epidemiological, clinical, radiographic and histopathological characteristics were recorded and analysed.
Results: Osteosarcomas occurred more frequently in males with a mean age of 40 years, while chondrosarco- mas showed a female predilection and the mean age of patients was 44 years. Clinically, all neoplasms were de- scribed as swellings, occasionally ulcerated, most com- monly located in the mandible, with variable radiographic appearance. The predominant histologic subtype of osteosarcomas was chondroblastic, while most of them as well as all of the chondrosarcomas were poorly differentiated.
KEY WORDS: chondrosarcoma, jaws, neoplasm, os- teosarcoma, tumor.
REFERENCES
Ajagbe HA, Daramola JO, Junaid TA: Chondrosarcoma of the jaw: Re- view of fourteen cases. J Oral Maxillofac Surg 43:763-766, 1985 Ajagbe HA, Junaid TA, Daramola JO: Osteogenic sarcoma of the jaw in an African community: report of twenty-one cases. J Oral Max-
illofac Surg 44:104-106, 1986
Ajura A, Lau S: A retrospective clinicopathological study of 59 os- teogenic sarcoma of jaw bone archived in stomatology unit. Malays J Pathol 32:27-34, 2010
Amary MF, Ye H, Forbes G, Damato S, Maggiani F, Pollock R, Tira- bosco R et al: Isocitrate dehydrogenase 1 mutations (IDH1) and p16/CDKN2A copy number change in conventional chondrosar- comas. Virchows Arch 466:217-222, 2015
Baumhoer D, Brunner P, Eppenberger-Castori SE, Smida J, Nathrath M, Jundt G: Osteosarcomas of the jaws differ from their peripheral counterparts and require a distinct treatment approach, Experi- ences from the DOESAK Registry. Oral Oncology 50:147-153, 2014
Bertoni F, Dallera P, Bacchini P, Marchetti C, Campobassi A: The Insti- tuto Rizzoli-Beretta experience with osteosarcoma of the jaw. Cancer 68:1555-1563, 1991
Calvert GT, Randall RL, Jones KB, Cannon-Albright L, Lessnick S, Schiff- man JD: At-risk populations for osteosarcoma: the syndromes and beyond. Sarcoma 2012, 2012: 152382
Capasso LL: Antiquity of Cancer. Int J Cancer 113:2-13, 2005
Cheng YS, Wright JM, Walstad WR, Finn MD: Osteosarcoma arising in Paget's disease of the mandible. Oral Oncol 38:785-792, 2002 Clark L, Unni KK, Dahlin DC: Osteosarcoma of the jaw. Cancer
51:2311-2316, 1983
Coca-Pelaz A, Rodrigo JP, Triantafyllou A, Hunt JL, Fernandez-Miranda JC, Strojan P, de Bree R et al: Chondrosarcomas of the head and neck. Eur Arch Otorhinolaryngol 271:2601-2609, 2014
Fernandes R, Nikitakis NG, Pazoki A, Ord RA: Osteogenic sarcoma of the jaw: a 10-year experience. J Oral Maxillofac Surg 65:1286- 1291, 2007
Finn DG, Goepfert H, Batsakis JG: Chondrosarcoma of the head and neck. Laryngoscope 94:1539-1544, 1984
Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F (eds): World Health Organisation Classification of Tumours. Pathology and Ge- netics of Tumours of Soft Tissue and Bone. 4th edition. IARC 2013
Garrington GE, Collett WK: Chondrosarcoma II. Chondrosarcoma of the jaws: analysis of 37 cases. J Oral Pathol 17:12-20, 1988 Garrington GE, Scofield HH, Cornyn J, Hooker SP: Osteosarcoma of
the jaws: analysis of 56 cases. Cancer 20:377-391, 1967
Gorsky M, Epstein JB: Craniofacial osseous and chondromatous sarco- mas in British Columbia: a review of 34 cases. Oral Oncology 36:27-31, 2000
Granowski-LeCornu M, Chuang SK, Kaban LB, August M: Osteosar- coma of the Jaws: Factors Influencing Prognosis. J Oral Maxillofac- Surg 69:2368-2375, 2011
Guadagnolo BA, Zagars GK, Raymond AK, Benjamin RS, Sturgis EM: Osteosarcoma of the jaw/craniofacial region: outcomes after mul- timodality treatment. Cancer 115:3262-3270, 2009
Hackney FL, Aragon SB, Aufdemorte TB, Holt GR, Van Sickels JE: Chondrosarcoma of the jaws: Clinical findings, histopathology, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 71:139-143, 1991
Huvos AG, Woodard HQ, Cahan WG, Higinbotham NL, Stewart FW, Butler A, Bretsky SS: Postradiation osteogenic sarcoma of bone and soft tissues. A clinicopathologic study of 66 patients. Cancer 55:1244-1255, 1985
Jaffe N, Bruland OS, Bielack SS: Pediatric and adolescent osteosarcoma.
Springer 2009, pp: 6-7, 20-21, 531
Kämmerer PW, Shabazfar N, Makoie NV, Moergel M, Al-Nawas B: Clinical, therapeutic and prognostic features of osteosarcoma of the jaws-Experience of 36 cases. J Craniomaxillofac Surg 40:541- 548, 2012
Kassir RR, Rassekh CH, Kinsella JB, Segas J, Carrau RL, Hokanson JA: Osteosarcoma of the head and neck: meta-analysis of nonran- domized studies. Laryngoscope 107:56-61, 1997
Koch BB, Karnell LH, Hoffman HT, Apostolakis LW, Robinson RA, Zhen W, Menck HR: National cancer database report on chon- drosarcoma of the head and neck. Head Neck 22:408-425, 2000
Lee RJ, Arshi A, Schwartz HC, Christensen RE: Characteristics and prognostic factors of osteosarcoma of the jaws: a retrospective cohort study. JAMA Otolaryngol Head Neck Surg 141:470-477, 2015
Lichtenstein L, Jaffe HI: Chondrosarcoma of bone. Am J Pathol 19:553- 558, 1943
Lin PP, Moussallem CD, Deavers MT: Secondary Chondrosarcoma. J Am Acad Orthop Surg 18:608-615, 2010
Mardinger O, Givol N, Talmi YP, Taicher S: Osteosarcoma of the jaw: The Chaim Sheba Medical Center Experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 91:445-451, 2001
Mavrogenis AF, Gambarotti M, Angelini A, Palmerini E, Staals EL, Rug- gieri P, Papagelopoulos PJ: Chondrosarcomas revisited. Orthope- dics 35:379-390, 2012
McHugh JB, Thomas DG, Herman JM, Ray ME, Baker LH, Adsay NV, Rabah R et al: Primary versus Radiation-Associated Craniofacial Osteosarcoma Biologic and Clinicopathologic Comparisons. Can- cer 107:554-562, 2006
Mücke T, Mitchell DA, Tannapfel A, Wolff KD, Loeffelbein DJ, Kanatas A: Effect of neoadjuvant treatment in the management of os- teosarcomas of the head and neck. J Cancer Res Clin Oncol 140:127-131, 2014
Nakayama E, Sugiura K, Ishibashi H, Oobu K, Kobayashi I, Yoshiura K. The clinical and diagnostic imaging findings of osteosarcoma of the jaw. Dentomaxillofac Radiol 34: 182-188, 2005
Neville BW, Damm DD, Allen CM, Bouquot JE: Oral and Maxillofacial Pathology. 3rd edition. Saunders Elsevier 2008, pp. 660-667 Paparella ML, Olvi LG, Brandizzi D, Keszler A, Santini-Araujo E, Cabrini
RL: Osteosarcoma of the jaw: an analysis of a series of 74 cases. Histopathology 63:551-557, 2013
Prado FO, Nishimoto IN, Perez DE,Kowalski LP, Lopes MA: Head and neck chondrosarcoma: analysis of 16 cases. Br J Oral Maxillofac Surg 47:555-557, 2009
Regezi JA, Sciubba JJ, Jordan RCK: Oral Pathology: Clinical Pathologic Correlations. 6th edition, Saunders Elsevier 2012, pp. 328-338
Saito K, Unni KK, Wollan PC, Lund BA: Chondrosarcoma of the jaw and facial bones. Cancer 76:1550-1558, 1995
Salvati M, Ciappetta P, Raco A: Osteosarcomas of the skull. Clinicalre- marks on 19 cases. Cancer 71:2210-2216, 1993
Sammartino G, Marenzi G, Howard CM, Minimo C, Trosino O, Califano L, Claudio PP: Chondrosarcoma of the jaw: a closer look at its management. J Oral Maxillofac Surg 66:2349-2355, 2008
Samuel AM, Costa J, Lindskog DM: Genetic alterations in chondrosar- comas-keys to targeted therapies? Cell Oncol (Dordr) 37:95-105, 2014
Sato K, Nukaga H, Horikoshi T, Smeele LE, Kostense PJ, van der Waal I, Snow GB: Chondrosarcoma of the jaws and facial skeleton: a review of the Japanese literature. J Oral Surg 35:892-897, 1977
Smeele LE, Kostense PJ, van der Waal I, Snow GB: Effect of chemother- apy on survival of craniofacial osteosarcoma: A systematic review of 201 patients. J Clin Oncol 15:363-367, 1997
Thariat J, Schouman T, Brouchet A, Sarini J, Miller RC, Reychler H, Ray- Coquard I et al: Osteosarcomas of the mandible: multidisciplinary management of a rare tumor of the young adult, a cooperative study of the GSF-GETO, Rare Cancer Network, GETTEC/REF- COR and SFCE. Ann Oncol 24:824-831, 2013
Triantafyllidou A, Psomaderis K, Iordanidis F, Karakasis D: Osteosar- coma of the mandible arising de novo in fibrous dysplasia. Case report and review of the literature. Hellenic Arch Oral Maxillofac Surg 1:33-40, 2012
Unni KK, Inwards CY: Dahlin’s Bone Tumors: General Aspects and Data on 10,165 Cases. 6th edition. Lippincott Williams & Wilkins 2010, pp. 60-91, 122-157
Wang L, Motoi T, Khanin R, Olshen A, Mertens F, Bridge J, Dal Cin P et al: Identification of a novel, recurrent HEY1-NCOA2 fusion in mesenchymal chondrosarcoma based on a genome-wide screen of exon-level expression data. Genes Chromosomes Cancer 51:127-139, 2012
Wang S, Shi H, Yu Q: Osteosarcoma of the Jaws: Demographic and CT Imaging Features. Dentomaxillofacial Radiology 41:37-42, 2012
Wožniak AW, Nowaczyk MT, Osmola K, Golusinski W: Malignant transformation of an osteoblastoma of the mandible: case report and review of the literature. Eur Arch Otorhinolaryngol 267:845- 849, 2010
Wright JM, Vered M: Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: Odon- togenic and Maxillofacial Bone Tumors. Head Neck Pathol 11:68- 77, 2017
Yoshida A, Ushiku T, Motoi T, Shibata T, Beppu Y, Fukayama M, Tsuda H: Immunohistochemical analysis of MDM2 and CDK4 distin- guishes low-grade osteosarcoma from benign mimics. Mod Pathol 23:1279-1288, 2010
Department of Oral Medicine and Pathology, School of Dentistry, National and Kapodistrian University of Athens, Greece (Head: Professor A. Sklavounou)
Hellenic Archives of Oral & Maxillofacial Surgery (2017) 3, 115-128
SUMMARY: Οsteosarcomas and chondrosarcomas of the jaws are extremely rare malignant neoplasms, representing only a small number of the total sarcomas of the skeleton.
Materials and methods: The retrospective study of the histopathology archives of the Department of Oral Medicine and Pathology during the period 1970-2016 re- vealed 12 osteosarcomas and 5 chondrosarcomas of the jaws, in a total of 33,542 biopsies of the corresponding period. Their epidemiological, clinical, radiographic and histopathological characteristics were recorded and analysed.
Results: Osteosarcomas occurred more frequently in males with a mean age of 40 years, while chondrosarco- mas showed a female predilection and the mean age of patients was 44 years. Clinically, all neoplasms were de- scribed as swellings, occasionally ulcerated, most com- monly located in the mandible, with variable radiographic appearance. The predominant histologic subtype of osteosarcomas was chondroblastic, while most of them as well as all of the chondrosarcomas were poorly differentiated.
KEY WORDS: chondrosarcoma, jaws, neoplasm, os- teosarcoma, tumor.
REFERENCES
Ajagbe HA, Daramola JO, Junaid TA: Chondrosarcoma of the jaw: Re- view of fourteen cases. J Oral Maxillofac Surg 43:763-766, 1985 Ajagbe HA, Junaid TA, Daramola JO: Osteogenic sarcoma of the jaw in an African community: report of twenty-one cases. J Oral Max-
illofac Surg 44:104-106, 1986
Ajura A, Lau S: A retrospective clinicopathological study of 59 os- teogenic sarcoma of jaw bone archived in stomatology unit. Malays J Pathol 32:27-34, 2010
Amary MF, Ye H, Forbes G, Damato S, Maggiani F, Pollock R, Tira- bosco R et al: Isocitrate dehydrogenase 1 mutations (IDH1) and p16/CDKN2A copy number change in conventional chondrosar- comas. Virchows Arch 466:217-222, 2015
Baumhoer D, Brunner P, Eppenberger-Castori SE, Smida J, Nathrath M, Jundt G: Osteosarcomas of the jaws differ from their peripheral counterparts and require a distinct treatment approach, Experi- ences from the DOESAK Registry. Oral Oncology 50:147-153, 2014
Bertoni F, Dallera P, Bacchini P, Marchetti C, Campobassi A: The Insti- tuto Rizzoli-Beretta experience with osteosarcoma of the jaw. Cancer 68:1555-1563, 1991
Calvert GT, Randall RL, Jones KB, Cannon-Albright L, Lessnick S, Schiff- man JD: At-risk populations for osteosarcoma: the syndromes and beyond. Sarcoma 2012, 2012: 152382
Capasso LL: Antiquity of Cancer. Int J Cancer 113:2-13, 2005
Cheng YS, Wright JM, Walstad WR, Finn MD: Osteosarcoma arising in Paget's disease of the mandible. Oral Oncol 38:785-792, 2002 Clark L, Unni KK, Dahlin DC: Osteosarcoma of the jaw. Cancer
51:2311-2316, 1983
Coca-Pelaz A, Rodrigo JP, Triantafyllou A, Hunt JL, Fernandez-Miranda JC, Strojan P, de Bree R et al: Chondrosarcomas of the head and neck. Eur Arch Otorhinolaryngol 271:2601-2609, 2014
Fernandes R, Nikitakis NG, Pazoki A, Ord RA: Osteogenic sarcoma of the jaw: a 10-year experience. J Oral Maxillofac Surg 65:1286- 1291, 2007
Finn DG, Goepfert H, Batsakis JG: Chondrosarcoma of the head and neck. Laryngoscope 94:1539-1544, 1984
Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F (eds): World Health Organisation Classification of Tumours. Pathology and Ge- netics of Tumours of Soft Tissue and Bone. 4th edition. IARC 2013
Garrington GE, Collett WK: Chondrosarcoma II. Chondrosarcoma of the jaws: analysis of 37 cases. J Oral Pathol 17:12-20, 1988 Garrington GE, Scofield HH, Cornyn J, Hooker SP: Osteosarcoma of
the jaws: analysis of 56 cases. Cancer 20:377-391, 1967
Gorsky M, Epstein JB: Craniofacial osseous and chondromatous sarco- mas in British Columbia: a review of 34 cases. Oral Oncology 36:27-31, 2000
Granowski-LeCornu M, Chuang SK, Kaban LB, August M: Osteosar- coma of the Jaws: Factors Influencing Prognosis. J Oral Maxillofac- Surg 69:2368-2375, 2011
Guadagnolo BA, Zagars GK, Raymond AK, Benjamin RS, Sturgis EM: Osteosarcoma of the jaw/craniofacial region: outcomes after mul- timodality treatment. Cancer 115:3262-3270, 2009
Hackney FL, Aragon SB, Aufdemorte TB, Holt GR, Van Sickels JE: Chondrosarcoma of the jaws: Clinical findings, histopathology, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 71:139-143, 1991
Huvos AG, Woodard HQ, Cahan WG, Higinbotham NL, Stewart FW, Butler A, Bretsky SS: Postradiation osteogenic sarcoma of bone and soft tissues. A clinicopathologic study of 66 patients. Cancer 55:1244-1255, 1985
Jaffe N, Bruland OS, Bielack SS: Pediatric and adolescent osteosarcoma.
Springer 2009, pp: 6-7, 20-21, 531
Kämmerer PW, Shabazfar N, Makoie NV, Moergel M, Al-Nawas B: Clinical, therapeutic and prognostic features of osteosarcoma of the jaws-Experience of 36 cases. J Craniomaxillofac Surg 40:541- 548, 2012
Kassir RR, Rassekh CH, Kinsella JB, Segas J, Carrau RL, Hokanson JA: Osteosarcoma of the head and neck: meta-analysis of nonran- domized studies. Laryngoscope 107:56-61, 1997
Koch BB, Karnell LH, Hoffman HT, Apostolakis LW, Robinson RA, Zhen W, Menck HR: National cancer database report on chon- drosarcoma of the head and neck. Head Neck 22:408-425, 2000
Lee RJ, Arshi A, Schwartz HC, Christensen RE: Characteristics and prognostic factors of osteosarcoma of the jaws: a retrospective cohort study. JAMA Otolaryngol Head Neck Surg 141:470-477, 2015
Lichtenstein L, Jaffe HI: Chondrosarcoma of bone. Am J Pathol 19:553- 558, 1943
Lin PP, Moussallem CD, Deavers MT: Secondary Chondrosarcoma. J Am Acad Orthop Surg 18:608-615, 2010
Mardinger O, Givol N, Talmi YP, Taicher S: Osteosarcoma of the jaw: The Chaim Sheba Medical Center Experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 91:445-451, 2001
Mavrogenis AF, Gambarotti M, Angelini A, Palmerini E, Staals EL, Rug- gieri P, Papagelopoulos PJ: Chondrosarcomas revisited. Orthope- dics 35:379-390, 2012
McHugh JB, Thomas DG, Herman JM, Ray ME, Baker LH, Adsay NV, Rabah R et al: Primary versus Radiation-Associated Craniofacial Osteosarcoma Biologic and Clinicopathologic Comparisons. Can- cer 107:554-562, 2006
Mücke T, Mitchell DA, Tannapfel A, Wolff KD, Loeffelbein DJ, Kanatas A: Effect of neoadjuvant treatment in the management of os- teosarcomas of the head and neck. J Cancer Res Clin Oncol 140:127-131, 2014
Nakayama E, Sugiura K, Ishibashi H, Oobu K, Kobayashi I, Yoshiura K. The clinical and diagnostic imaging findings of osteosarcoma of the jaw. Dentomaxillofac Radiol 34: 182-188, 2005
Neville BW, Damm DD, Allen CM, Bouquot JE: Oral and Maxillofacial Pathology. 3rd edition. Saunders Elsevier 2008, pp. 660-667 Paparella ML, Olvi LG, Brandizzi D, Keszler A, Santini-Araujo E, Cabrini
RL: Osteosarcoma of the jaw: an analysis of a series of 74 cases. Histopathology 63:551-557, 2013
Prado FO, Nishimoto IN, Perez DE,Kowalski LP, Lopes MA: Head and neck chondrosarcoma: analysis of 16 cases. Br J Oral Maxillofac Surg 47:555-557, 2009
Regezi JA, Sciubba JJ, Jordan RCK: Oral Pathology: Clinical Pathologic Correlations. 6th edition, Saunders Elsevier 2012, pp. 328-338
Saito K, Unni KK, Wollan PC, Lund BA: Chondrosarcoma of the jaw and facial bones. Cancer 76:1550-1558, 1995
Salvati M, Ciappetta P, Raco A: Osteosarcomas of the skull. Clinicalre- marks on 19 cases. Cancer 71:2210-2216, 1993
Sammartino G, Marenzi G, Howard CM, Minimo C, Trosino O, Califano L, Claudio PP: Chondrosarcoma of the jaw: a closer look at its management. J Oral Maxillofac Surg 66:2349-2355, 2008
Samuel AM, Costa J, Lindskog DM: Genetic alterations in chondrosar- comas-keys to targeted therapies? Cell Oncol (Dordr) 37:95-105, 2014
Sato K, Nukaga H, Horikoshi T, Smeele LE, Kostense PJ, van der Waal I, Snow GB: Chondrosarcoma of the jaws and facial skeleton: a review of the Japanese literature. J Oral Surg 35:892-897, 1977
Smeele LE, Kostense PJ, van der Waal I, Snow GB: Effect of chemother- apy on survival of craniofacial osteosarcoma: A systematic review of 201 patients. J Clin Oncol 15:363-367, 1997
Thariat J, Schouman T, Brouchet A, Sarini J, Miller RC, Reychler H, Ray- Coquard I et al: Osteosarcomas of the mandible: multidisciplinary management of a rare tumor of the young adult, a cooperative study of the GSF-GETO, Rare Cancer Network, GETTEC/REF- COR and SFCE. Ann Oncol 24:824-831, 2013
Triantafyllidou A, Psomaderis K, Iordanidis F, Karakasis D: Osteosar- coma of the mandible arising de novo in fibrous dysplasia. Case report and review of the literature. Hellenic Arch Oral Maxillofac Surg 1:33-40, 2012
Unni KK, Inwards CY: Dahlin’s Bone Tumors: General Aspects and Data on 10,165 Cases. 6th edition. Lippincott Williams & Wilkins 2010, pp. 60-91, 122-157
Wang L, Motoi T, Khanin R, Olshen A, Mertens F, Bridge J, Dal Cin P et al: Identification of a novel, recurrent HEY1-NCOA2 fusion in mesenchymal chondrosarcoma based on a genome-wide screen of exon-level expression data. Genes Chromosomes Cancer 51:127-139, 2012
Wang S, Shi H, Yu Q: Osteosarcoma of the Jaws: Demographic and CT Imaging Features. Dentomaxillofacial Radiology 41:37-42, 2012
Wožniak AW, Nowaczyk MT, Osmola K, Golusinski W: Malignant transformation of an osteoblastoma of the mandible: case report and review of the literature. Eur Arch Otorhinolaryngol 267:845- 849, 2010
Wright JM, Vered M: Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: Odon- togenic and Maxillofacial Bone Tumors. Head Neck Pathol 11:68- 77, 2017
Yoshida A, Ushiku T, Motoi T, Shibata T, Beppu Y, Fukayama M, Tsuda H: Immunohistochemical analysis of MDM2 and CDK4 distin- guishes low-grade osteosarcoma from benign mimics. Mod Pathol 23:1279-1288, 2010
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