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CPC 8
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A 21 year old female had developed this swelling of the right side of the posterior mandible over a period of several weeks. Radiographically there was a large destructive radiolucent lesion which on surgical exploration was found to perforate the cortical plate.


Differential Diagnosis:

  1. Osteogenic Sarcoma
  2. Fibrosarcoma
  3. Ameloblastoma
Due to the rapid progression and destruction of this lesion, a malignant neoplasm should be considered. However, since the radiograph is not highly diagnostic, the possibility of a less aggressive tumor which may have become infected, also must be considered.



Histology:

Slide 1 (medium power, H&E). From left to right, this slide demonstrates a cellular tumor containing numerous mitoses with atypia, osteoclasts, and newly formed osteoid surrounded by plump osteoblasts.








Slide 2 (high power, H&E). This slide shows osteoid surrounded by and including cells with vesicular nuclei and prominent nucleoli. There are also cells with large, basophilic irregularly-shaped nuclei.








Diagnosis: Osteogenic Sarcoma