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OBJECTIVE: A report of a rare case of parosteal osteosarcoma, a low-grade malignant lesion diagnosed in our Centre, and to highlight the diagnostic challenges, treatment considerations and prognosis of the lesion; compared to other reactive, benign and malignant jaw lesions.
CASE REPORT: A 67 years old female who presented with a slow growing oval shaped, well circumscribed, bony hard, left maxillary swelling of 4 months duration; extending from the region of the left upper lateral incisor tooth (22) to the left upper first molar tooth (26) and fixed to the overlying gingiva. Oblique lateral radiograph showed the left maxillary labial alveolus with lobulated ossified mass. The clinical differential diagnoses of the lesion were osteoma and fibrous dysplasia. Histopathological diagnosis of parosteal osteosarcoma was made after incisional biopsy of the lesion. Surgical resection (with wide margin) of the affected maxillary segment and the associated teeth was performed and post-surgical biopsy confirmed the diagnosis of parosteal osteosarcoma. No recurrence was observed after 4 years follow up of the patient.
CONCLUSION: Parosteal osteosarcoma shares similar clinico-pathological characteristics with some periosteal lesions. However, special imaging techniques and histopathological evaluation remains the most reliable tools for definitive diagnosis of these lesions. This study recommends close cooperation between Oral and Maxillofacial Surgeons, Pathologists and Radiologists in the management of parosteal osteosarcoma.