下顎骨に生じた骨肉腫の2例

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Osteosarcoma is second only to multiple myeroma in the incidence of tumours of bone, but its occurrence in the mandible is relatively rare. This article reports on two cases of osteosarcoma in the mandible. Case 1: A 47-year-old female complained of paresthesia of the right mental region. Osteomyelitis of the mandible was suspected on clinical examination. After extraction of the lower right second molar, the right molar region of the mandible rapidly swelled and tumorous tissue developed in the tooth socket. Radiation therapy was chosen since malignant lymphoma was suspected based on histopathological findings, but the swelling increased. On histopathological re-examination, a diagnosis of osteosarcoma was established. Although high dose methotrexate (MTX)-citrovorum factor (CF) therapy was instituted (100-200 mg/kg) after radical surgery the patient died of pneumonia resulting from lung metastasis. Case 2: A 48-year-old male complained of swelling in the right molar region of the mandible. Examination revealed tumorous tissue with sequestration in the molar region. Based on histologic examination, a diagnosis of fibroosseous lesion was made. Marginal resection of the mandible was performed, but local recurrence was noted 6 months later. Histologic examination of the second biopsy was negative for malignancy, and segmental resection was performed. However, swelling of the mandible recurred soon after the 2nd operation. The patient underwent further surgery, and a final diagnosis of osteosarcoma was reached. High dose MTX-CF therapy was instituted soon after surgery. There has been no sign of recurrence or metastasis in the 2 years since the 3 rd operation.

下顎骨に生じた骨肉腫の2例

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