SUNRAY APPEARANCE ON SONOGRAPHY IN OSTEOSARCOMA OF THE MANDIBLE: A RARE CASE REPORT

Öz

Osteosarcoma comprises 23% of head and neck malignancies. Studies show that 6% to 9% of all osteosarcomas are seen in the maxilla and mandible. In osteosarcoma in jaws, the survival rate is higher and the risk of metastasis is lower compared to osteosarcoma in the extremities. The gold standard in osteosarcoma diagnosis is computed tomography and magnetic resonance imaging. ‘Sunray appearance’ is a common radiologic finding of sarcomas. A 29-year-old male patient received to our clinic with pain and swelling in the right mandible. Extra-oral examination revealed that facial asymmetry and significant swelling in the right mandible. On the cone beam computerized tomography examination, a lytic, mixed lesion area was observed with conical shaped root resorption around the mandibular right second premolar and first molar tooth roots. Ultrasound examination revealed that thinning, expansion, and erosion of the buccal cortical bone and 'sunray appearance' in the mandible. Cone beam computerized tomography and ultrasound have become an important diagnostic technique for the evaluation of maxillofacial pathologies. Ultrasound imaging is a rapid technique that aids in the early and differential diagnosis of pathologies. Sunray appearance is a pathognomic finding for osteosarcoma. In present case report, diagnostic ultrasonography is the second case in the literature used in osteosarcoma of the mandible. Keywords: Cone beam computed tomography, jaw osteosarcoma, sunray, ultrasonography MANDİBULA OSTEOSARKOMUNDA ULTRASONOGRAFİDE GÜNEŞ IŞINI GÖRÜNÜMÜ: NADİR BİR OLGU SUNUMU ÖZ Osteosarkom, baş ve boyun malignitelerinin % 23'ünü oluşturur. Çalışmalar, tüm osteosarkomların % 6 ila % 9'unun maksilla ve mandibulada görüldüğünü göstermektedir. Çenelerde görülen osteosarkomda sağkalım oranı daha yüksektir ve metastaz riski ekstremitelerde görülen osteosarkom ile karşılaştırıldığında daha düşüktür. Osteosarkom tanısında altın standart bilgisayarlı tomografi ve manyetik rezonans görüntülemedir. Radyografik olarak, “güneş ışını görünümü” sarkomların yaygın bir bulgusudur. 29 yaşında erkek hasta kliniğimize sağ mandibulada ağrı ve şişlik ile başvurdu. Ekstraoral muayenede, yüz asimetrisi ve sağ mandibular çenede belirgin şişlik gözlendi. Konik ışınlı bilgisayarlı tomografi incelemesinde, mandibular sağ ikinci premolar ve birinci molar diş kökleri çevresinde konik şekilli kök rezorpsiyonu ile litik, karışık bir lezyon alanı gözlenmiştir. Ultrasonografide ise, mandibulada bukkal korteksin kemik incelmesi, erozyonu ve “güneş ışını görünümü” gözlenmiştir. Konik ışınlı bilgisayarlı tomografi ve ultrasonografi, maksillofasiyal patolojilerin değerlendirilmesi için önemli bir tanı tekniği haline gelmiştir. Ultrasonografi, patolojilerin erken ve ayırıcı tanısına yardımcı olan hızlı bir tekniktir. Güneş ışını görünümü osteosarkom için patognomik bir bulgudur. Sunduğumuz olgu; mandibula osteosarkomunun tanısında ultrasonografi kullanılan literatürdeki ikinci olgudur. Anahtar Kelimeler: Çene osteosarkomu, güneş ışını, konik ışınlı bilgisayarlı tomografi, ultrasonografi

Anahtar Kelimeler

• ultrasonography
• jaw osteosarcoma,
• Cone beam computed tomography,

SUNRAY APPEARANCE ON SONOGRAPHY IN OSTEOSARCOMA OF THE MANDIBLE: A RARE CASE REPORT

Öz

Osteosarcoma comprises 23% of head and neck malignancies. Studies show that 6% to 9% of all osteosarcomas are seen in the maxilla and mandible. In osteosarcoma in jaws, the survival rate is higher and the risk of metastasis is lower compared to osteosarcoma in the extremities. The gold standard in osteosarcoma diagnosis is computed tomography and magnetic resonance imaging. ‘Sunray appearance’ is a common radiologic finding of sarcomas. A 29-year-old male patient received to our clinic with pain and swelling in the right mandible. Extra-oral examination revealed that facial asymmetry and significant swelling in the right mandible. On the cone beam computerized tomography examination, a lytic, mixed lesion area was observed with conical shaped root resorption around the mandibular right second premolar and first molar tooth roots. Ultrasound examination revealed that thinning, expansion, and erosion of the buccal cortical bone and 'sunray appearance' in the mandible. Cone beam computerized tomography and ultrasound have become an important diagnostic technique for the evaluation of maxillofacial pathologies. Ultrasound imaging is a rapid technique that aids in the early and differential diagnosis of pathologies. Sunray appearance is a pathognomic finding for osteosarcoma. In present case report, diagnostic ultrasonography is the second case in the literature used in osteosarcoma of the mandible. Keywords: Cone beam computed tomography, jaw osteosarcoma, sunray, ultrasonography

Anahtar Kelimeler

• Cone beam computed tomography
• jaw osteosarcoma, sunray,

Kaynakça

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