Osteosarcoma of the jaw in an adult patient aged more than 40 years successfully treated with neoadjuvant chemotherapy comprising doxorubicin and ifosfamide: A case report

Although the mandible is the fourth most common site for osteosarcoma, the standard treatment for these patients remains unclear. A 59-year-old woman presented with mandibular pain. Imaging studies revealed a bone-forming mass with extraosseous extension in the mandible. Biopsy results revealed spindle-to-stellate tumour cells with irregular nuclei and osteoid formation, indicating high-grade osteosarcoma. After preoperative chemotherapy with doxorubicin and ifosfamide, osteosarcoma of the jaw was resected with adequate margins. Histological analysis revealed > 90 % tumour necrosis. Patients achieving a tumour necrosis rate of > 90 % after preoperative chemotherapy have shown significantly better prognoses than those with a necrosis rate of < 90 % in osteosarcoma of the extremities and trunk. Although no consensus has been reached on the effectiveness of preoperative chemotherapy for osteosarcoma of the jaw or osteosarcoma in patients aged > 40 years, neoadjuvant chemotherapy with doxorubicin and ifosfamide may achieve favorable oncological outcomes in selected patients aged > 40 years with high-grade osteosarcoma of the jaw.