CASE REPORTS   

Rivista Italiana di Chirurgia Maxillo-Facciale 2005 January-December;16(1-3):63-6

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English

Osteosarcoma of the jaw reconstructed with free fibula flap

Bertolai R. ¹, Agostini T. ², Agostini V. ²

¹ Department of Maxillo-Facial Surgery University of Florence, Florence, Italy 2 Department of Plastic and Reconstructive Surgery University of Florence, Florence, Italy

Although osteosarcoma of the jaw (OSJ) is the most frequent primary malignant bone tumor in the jaw, it is nevertheless a rare malignancy. Mandibular tumors arise more frequently in the posterior body and horizontal ramus rather than the ascending ramus. Swelling and pain are the most common symptoms. Some patients report symptoms for relatively long periods before diagnosis, which indicates that osteosarcomas of the jaw grow rather slowly and therefore they represent a therapeutic challenge because surgical margins are difficult to obtain due to aesthetic and functional concerns. Today surgery with wide resection margins is the mainstay of treatment. The patient observed is a 69 years old man affected by an osteosarcoma of the jaw, who had had a long story of surgical operations due to a benign tumor, which probably had transformed in a malignant bone tumor, osteosarcoma. The surgical procedure had consisted in a wide resection of the hemijaw interested by the tumor and in a reconstruction using a fibula free flap. The follow up period amounts to three years up today; monthly medical examinations have been performed and annually a computer tomography of maxillo-facial had been performed. No recurrence of disease had been appeared and the patient has a good quality of life, with a satisfactory aesthetic result, good speech and mastication.