Most common primary malignancy of bone

Risk factors:

• Irradiation
• Paget’s disease

Clinical:

• Asymmetrical jaw swelling
• Painful firm swelling
• Loosening of teeth
• Parasthesia
• Nasal obstruction
• Rapid local growth – early metastasis (lungs)

Radiology:

• Poorly defined margin – Sunburst appearance
• Radiolucent
• Dense sclerosis/mixed sclerosis
• Widening PDL space
• Moth eaten appearance

Histology:

• Malignant mesenchymal cells – produce osteoid
• Cells are spindle shaped – pleomorphic with bizarre nuclear and cytoplasmic shapes
• Osteoid formation + atypical osteoblasts + cartilage + fibrous tissue
• Abnormal mitosis

Subtypes: Depending on amount of osteoid, collagen and cartilage

• Osteoblastic
• Chondroblastic
• Fibroblastic

Management:

• Radical excision surgery + radiotherapy
• Poor prognosis: 30-50% survival rate
• 50% recurring in 1st year

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