Clinical and radiographic characteristics of osteosarcomas of the jaws: A retrospective study.

Background: Osteosarcomas in the maxillofacial region are rare and present different clinical and epidemiological aspects than those diagnosed in the long bones. This retrospective cross-sectional observational study aimed to report the characteristics of osteosarcomas of the jaws diagnosed in an oral pathology reference laboratory. Material and Methods: Information (gender, location of origin, age, symptoms, lesion evolution time, and clinical appearance) regarding the cases diagnosed as osteosarcomas between 2001 and 2023 were obtained from histopathology reports, exam request forms, and clinical photographs. All radiographs were evaluated on a high-resolution screen by a previously trained radiologist. A 20-year experienced pathologist reviewed the histopathological slides and determined the predominant matrix of the lesions: osteoblastic, chondroblastic, or fibroblastic. Results: Seventeen out of 33,692 cases diagnosed by the oral pathology laboratory over 22 years were osteosarcomas and 10 were included for analysis. The majority were diagnosed in males (60%) and the overall mean age was 37.8±21.6 years. A swollen, reddish, and ulcerated area was the most common clinical appearance. The mean evolution time of the lesions was 5.2±6.6 months. The majority of osteosarcomas were histologically classified as osteoblastic (80%). The radiographic appearance of the lesions was predominantly mixed (60%), presenting tooth resorption (44.4%) or displacement (33.3%), pericementum thickening (55.5%), mandibular canal erosion (71.4%) and sunray periosteal reaction (80%). Conclusions: The osteosarcomas of the jaws are predominantly osteoblastic with a swollen, reddish, and ulcerated clinical appearance. Imaging exams reveal mixed lesions with sunray periosteal reaction.