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Case Report



Maxillary osteosarcoma masquerading as chronic sinusitis—an intriguing case for surgical pathologists

Soham Chakraborty, Jayati Datta, Manisha Mahata, Sanghamitra Mukherjee, Tushar Kanti Das.




Abstract

Osteosarcoma is a highly aggressive malignant bone tumor in which the neoplastic osteoblasts produce osteoid material. This tumor almost exclusively involves the metaphysis of long bones. Involvement of flat bones such as the skull, jaw, and spine are extremely rare. A 22-year-old male patient presented with left-sided nasal obstruction and a painless swelling over the left cheek. On physical examination, a hard, nontender swelling was palpable over the left maxillary region. Computerized tomography (CT) scan of paranasal sinuses revealed that the left maxillary antrum presented an expansile, ill-defined, mixed, radiopaque-radiolucent lesion, invading the cortical bone and adjacent soft tissues. Left hemimaxillectomy was performed including a wide excision of the tumor. On gross examination, a hard bony growth was found in the maxilla. Microscopic examinations revealed histopathological features of osteosarcoma. Osteosarcoma of craniofacial region generally presents in advanced stage in the tertiary-care hospital, mainly, because of rarity of occurrence and lack of awareness. Its clinical features, histological characteristics, and close differential diagnosis are to be kept in mind to avoid late recognition, mutilating surgery, and associated morbidity.

Key words: Nasal obstruction, osteosarcoma, maxilla






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