Skull Base 2010; 20(3): 207-212
DOI: 10.1055/s-0029-1246221
CASE REPORT

© Thieme Medical Publishers

Multimodal Treatment of Osteogenic Sarcoma of the Jaw

Marton König1 , Jon Mork2 , Kirsten S. Hall3 , Terje Osnes2 , Torstein R. Meling1
  • 1Department of Neurosurgery, Rikshospitalet, Oslo University Hospital, Oslo, Norway
  • 2Department of ENT, Rikshospitalet, Oslo University Hospital, Oslo, Norway
  • 3Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
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Publikationsverlauf

Publikationsdatum:
05. Januar 2010 (online)

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ABSTRACT

Osteosarcomas (OSs) account for 40 to 60% of primary malignant bone tumors. About 10% occur in the head and neck region, frequently in the mandibula or maxilla. We treated a 30-year-old patient with 26-month history of right-sided facial pain and paresthesia. Investigation showed high-grade OS of the right mandibular coronoid process, affecting the mandibular nerve, middle cranial fossa, internal jugular vein, and internal carotid artery (ICA). True en bloc resection was performed after upfront adjuvant chemotherapy. The ICA was trap-ligated intradurally, whereafter the floor of the middle fossa, including the mandibular nerve and the glenoid fossa, was detached from the skull base in one piece. Subsequently, a hemimandibulectomy, total parotidectomy, ICA sacrifice, and removal of the pterygoid plates and muscles were performed, and the abovementioned structures were removed as a solitary specimen, including the facial nerve branches overlying the tumor. A sural nerve graft was interposed between five major facial nerve branches to reanimate the face. The patient had an uneventful recovery, is able to eat, and has a partial facial nerve palsy. He has no tumor recurrence 26 months after surgery. OS of the jaw should be treated with radical surgery as the primary modality.

REFERENCES

Torstein R MelingM.D. Ph.D. 

Department of Neurosurgery, The National Hospital

0027 Oslo, Norway

eMail: torstein.meling@rikshospitalet.no