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Radiation-induced osteosarcoma involving the mandible-Report of a rare diagnosis

机译：Radiation-induced osteosarcoma involving the mandible-Report of a rare diagnosis

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Background: Radiation-induced osteosarcomas of the jaws are a rare but often fatal consequence of radiation therapy in the head and neck region. Here we present a case of radiation-induced osteosarcoma of the mandible.Case Presentation: A male presented with severe trismus and marked left lingual alveolus expansion 1 year following extractions in the lower left quadrant. Four years previously, he had radical radiotherapy (70Gy) and chemotherapy for a p16-positive T1N2cM0 squamous cell carcinoma of the left tonsil with a positive left level II node. Initial bone biopsies of the left mandible showed a bony sequestrum suggestive of osteor-adionecrosis with the presence of abnormal osteoid suspicious of osteosarcoma. Imaging demonstrated an abnormal exophytic bone-forming lesion in the left mandibular body and parasymphysis and ruled out a metastatic lesion. The patient underwent bilateral neck dissection, left mandibulectomy with fibula flap reconstruction and full-thickness skin graft.Conclusions: Osteosarcoma should be considered if changes are seen in previously stable irradiated bone with bony destruction and a soft tissue mass. This case highlights the importance of synthesis of clinical, radiological and pathological findings in the diagnosis of such lesions, especially where the histology initially suggested a benign process.

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