RESUMO
BACKGROUND: Osteosarcoma of the jaw (JOS) constituting 5% to 13% of all osteosarcoma is a locally aggressive malignant mesenchymal tumor with high tendency to local recurrence and the ability to produce tumor osteoid. Compared to osteosarcoma of the remaining skeleton (SOS) JOS metastasizes relatively rarely and relatively late. It differs significantly from SOS in its biological behaviour. CASE REPORT: The presented case deals with a 60-year-old male patient suffering from a newly occurred polypous mucosal tumor of the right-sided maxillary alveolar ridge bioptically diagnosed as a granulation tissue polyp first. After transmaxillary resection of the tumor and consultation of a bone tumor reference center the final diagnosis of a high-grade chondroblastic osteosarcoma could be made. The recommended radical resection of the tumor was declined by the patient because of the expected cosmetic consequences. After surgical reduction of the rapidly growing sarcoma chemotherapy according to the COOS/EURO-B.O.S.S. protocol was initiated at a stage when computed tomography showed diffuse metastatic disease to the lungs. Chemotherapy could delay the progress of the disease only temporarily. The patient died from respiratory insufficiency. CONCLUSION: In JOS radical surgical resection is the therapy of first choice. For substantiation of the diagnosis and central registration of the cases a bone tumor reference center should be contacted.
Assuntos
Processo Alveolar/cirurgia , Neoplasias do Seio Maxilar/cirurgia , Osteossarcoma/cirurgia , Processo Alveolar/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Quimioterapia Adjuvante , Diagnóstico Diferencial , Progressão da Doença , Seguimentos , Humanos , Neoplasias Pulmonares/secundário , Masculino , Neoplasias do Seio Maxilar/diagnóstico , Neoplasias do Seio Maxilar/tratamento farmacológico , Neoplasias do Seio Maxilar/patologia , Pessoa de Meia-Idade , Osteossarcoma/diagnóstico , Osteossarcoma/tratamento farmacológico , Osteossarcoma/patologia , Tomografia Computadorizada por Raios XRESUMO
The outcome of vertical callus distraction of a segment of tooth-supporting alveolar process might be functionally and esthetically unsatisfactory because of the unidirectional impact of intraoral distraction devices. In this case report, we describe how, with a shortened consolidation phase and application of the floating bone effect, the tooth-supporting osteotomy segment can be successfully aligned 3 dimensionally. We applied orthodontic force systems that went beyond the unidirectional vector preset by the mechanical properties of the distraction device.