Sarcomas of the mandible. Literature review and case reports

Sarcomas of the maxillofacial region are rare tumors presenting with wide variety of histopathological and clinical features. The authors treated six patients with sarcomas of the mandible over a period of ten years: 2 patients with fibrosarcomas, 2 with lymphosarcomas, one with osteogenic sarcoma and one with chondrosarcoma. The patients' ages ranged from 28 to 65 years, one was male and five - female. The present study reports three cases (osteogenic sarcoma, fibrosarcoma, chondrosarcoma) with specific clinical and radiographic characteristics, demonstrating the differences between the various types of sarcomas. Special attention is paid to the first clinical signs and symptoms, and to the differential diagnosis with inflammatory conditions (post-extraction alveolitis, chronic odontogenic osteomyelitis), benign tumors (osteoblastoclastoma, ameloblastoma, odontogenic cysts, fibrous dysplasia) and centrally developing jaw carcinomas. Particular emphasis is given to CT imaging and morphological examinations in making an accurate diagnosis and providing adequate treatment. Early diagnosis and precise surgical treatment (total resection or hemiexarticulation, or neck dissection if submandibular or cervical metastases are present) are essential to achieve satisfactory management of these malignant neoplasms. The radiotherapy and chemotherapy administered according to the histologic features of the tumor are also of significance.