Osteosarcoma of the Maxilla and Maxillary Sinus Mimicking Post-Implant Infectious Complication: A Case Report

Autores/as

  • Thiago Miura Inacio Multiprofessional Residency Program in Cancer Care, Department of Dentistry and Stomatology, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. https://orcid.org/0009-0005-5583-3186
  • Mariana Andrade Costa Department of Dentistry and Stomatology, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. https://orcid.org/0000-0001-6689-2695
  • Maria Júlia Pagliarone Graduate Program in Clinical Oncology and Cell Therapy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. https://orcid.org/0000-0001-6687-4411
  • Tatiane Cristina Ferrari Department of Dentistry and Stomatology, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. https://orcid.org/0000-0002-1074-8181
  • Rodrigo Braz Campos Department of Pathology, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. https://orcid.org/0009-0001-9691-2156
  • Graziela Vieira Cavalcanti Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. https://orcid.org/0000-0002-7349-5273
  • Hilton Marcos Alves Ricz Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. https://orcid.org/0000-0002-3019-8949
  • Edwin Tomashiro Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. https://orcid.org/0000-0002-3153-6292
  • Leandro Dorigan de Macedo Department of Dentistry and Stomatology, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. https://orcid.org/0000-0001-9708-5845

DOI:

https://doi.org/10.5327/2525-5711.469

Palabras clave:

Osteosarcoma, Maxilla, Maxillary Sinus, Dental Implants, Oral Neoplasms

Resumen

Osteosarcoma is a rare malignant primary bone tumor in the gnathic bones and presents a locally aggressive behavior. Its diagnosis may be particularly challenging when it arises in uncommon sites such as the maxilla and maxillary sinus, especially in the presence of local conditions that simulate inflammatory or infectious processes. This study reports a case of high-grade osteosarcoma involving the maxilla and maxillary sinus in a female patient, initially misinterpreted as an infectious complication related to bone graft material extrusion following maxillary sinus floor elevation for dental implant placement. The patient presented delayed diagnosis and unfavorable clinical evolution, undergoing radical surgical resection followed by adjuvant radiotherapy and later palliative chemotherapy. This case highlights the diagnostic complexity of maxillofacial osteosarcomas and reinforces the importance of a multidisciplinary approach, careful interpretation of imaging findings, and early biopsy in atypical presentations to improve disease control and prognosis.

Citas

1. Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. 4th ed. St. Louis: Elsevier; 2016.

2. Rodriguez-Molinero J, Pozo-Kreilinger JJ, Ruiz-Roca JA, Lopez-Sanchez AF, Cebrian-Carretero JL. Clinical and pathological features of osteosarcomas of the jaws: a retrospective study. Clin Pract. 2024;14:965-79.

3. Soufflet E, Thibaut F. Case report of maxillary osteosarcoma with up-to-date review. J Oral Med Oral Surg. 2020;26(2):15.

4. Lim HJ, Ong CAJ, Tan JW, Teo MCC. Utility of positron emission tomography/computed tomography (PET/CT) imaging in the evaluation of sarcomas: a systematic review. Crit Rev Oncol Hematol. 2019;143:1-13.

5. Kalavrezos N, Sinha D. Head and neck sarcomas in adulthood: current trends and evolving management concepts. Br J Oral Maxillofac Surg. 2020;58:890-7.

6. Argyris PP, Dennis GR, Gopalakrishnan R, Koutlas IG, McNamara KK, Kalmar JR. Oral soft tissue and jawbone sarcomas: a retrospective clinicopathologic analysis of 128 cases from two institutions and comprehensive literature review. Head Neck Pathol. 2025;19(1):74.

7. Tossato PS, Pereira AC, Cavalcanti MGP. Osteossarcoma e condrossarcoma: diferenciação radiográfica por meio da tomografia computadorizada. Pesqui Odontol Bras. 2002;16:65-70.

8. Atarbashi-Moghadam S, Atarbashi-Moghadam F, Niazmand M, Shahrabi-Farahani S. Metastatic sarcomas of the oral cavity: a systematic review. J Stomatol Oral Maxillofac Surg. 2024;125(2):101656.

9. Bernhart G, Koob A, Schmitter M, Gabbert O, Stober T, Rammelsberg P. Clinical success of implant-supported and tooth-implant-supported double crown-retained dentures. Clin Oral Investig. 2012;16:1031-7.

10. August M, Magennis P, Dewitt D. Osteosarcoma of the jaws: factors influencing prognosis. Int J Oral Maxillofac Surg. 1997;26:198-204.

11. Takahama Junior A, Alves FA, Pinto CAL, Carvalho AL, Kowalski LP, Lopes MA. Clinicopathological and immunohistochemical analysis of head and neck osteosarcomas. Oral Oncol. 2003;39:521-30.

12. Carvalho MC, Colares DF, Morais HG, Gonzaga AK, Costa AD, Santos PP, et al. Clinical, radiographic and histopathological analysis of bone-forming tumors of the oral and maxillofacial region: a 53-year retrospective study. Med Oral Patol Oral Cir Bucal. 2026;31(4):e522-e530.

13. Javed F, Al-Askar M, Qayyum F, Wang HL, Al-Hezaimi K. Oral squamous cell carcinoma arising around osseointegrated dental implants. Implant Dent. 2012;21:280-6.

14. Jané-Salas E, López-López J, Roselló-Llabrés X, Rodríguez-Argueta OF, Küstner-Chimenos E. Relationship between oral cancer and dental implants: clinical cases and systematic review. Med Oral Patol Oral Cir Bucal. 2012;17:e935-40.

15. Moergel M, Karbach J, Kunkel M, Wagner W. Oral squamous cell carcinoma in the vicinity of dental implants. Clin Oral Investig. 2014;18:277-84.

16. Moore MM, Chua W, Charles KA, Clarke SJ. Inflammation and cancer: causes and consequences. Clin Pharmacol Ther. 2010;87:504-8.

17. Keel SB, Jaffe KA, Nielsen GP, Rosenberg AE. Orthopaedic implant-related sarcoma: a study of twelve cases. Mod Pathol. 2001;14:969-77.

18. Tayton KJ. Ewing’s sarcoma at the site of a metal plate. Cancer. 1980;45:413-5.

19. Kansara M, Teng MWL, Smyth MJ, Thomas DM. Translational biology of osteosarcoma. Nat Rev Cancer. 2014;14:722-35.

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Publicado

2026-08-24

Cómo citar

1.
Inacio TM, Costa MA, Pagliarone MJ, Ferrari TC, Campos RB, Cavalcanti GV, et al. Osteosarcoma of the Maxilla and Maxillary Sinus Mimicking Post-Implant Infectious Complication: A Case Report. J Oral Diagn [Internet]. 24 de agosto de 2026 [citado 16 de septiembre de 2026];. Disponible en: https://jordi.com.br/revista/article/view/469

Número

Sección

Case Report