Ossified Mandibular Mass: Osteosarcoma

An otherwise healthy adolescent girl presented with a mandibular swelling of 2 weeks’ duration. She reported paresthesia in the lower lip but denied pain or trismus. On examination, there was a firm mass with erythematous mucosa in the left oral vestibule. There was no lymphadenopathy in the neck. Computed tomography of the face showed a 3.2 4.3 2.8-cm osteoblastic destructive mass breaching the cortical boundary of the mandible and extending into the surrounding soft tissues (Figure 1). Magnetic resonance imaging showed peripheral enhancement of the extraosseous soft-tissue extension (Figures 2 and 3). Technetium bone scan showed intense focal uptake in the left mandibular body (Figure 4). Biopsy proved an intermediate-grade osteosarcoma.