ORAL AND MAXILLOFACIAL OSTEOSARCOMA: CASE REPORT

A 43-year-old female patient attended the oral maxillofacial and traumatology service presenting volume increase in the right hemiface with painful symptomatology. At the intraoral examination, an exophytic lesion involving the alveolar ridge and palate region was observed, extending to the right nostril. The lesion showed a partially ulcerated surface, with purulent secretion, firm consistency, and normal mucosal color. Computed tomography revealed a mixed appearance of hyperdensity and ill-defined hypodensity in the maxillary region with extension to the zygoma and the right orbit. Because of poor oral hygiene and a history of regression with antibiotic therapy, a clinical diagnosis of actinomycosis was issued, and incisional biopsy of the lesion was subsequently performed. In the microscopic analysis, proliferation of pleomorphic and atypical malignant mesenchymal cells was associated with deposition of osteoid matrix, thus confirming the histopathologic diagnosis of osteosarcoma. The patient was referred to the State Reference Center for appropriate treatment.