Lofgren Daniel H, Hilton Daniel B, Brown Jens C, Ramirez Carlos
Otolaryngology, McLaren Oakland Hospital, Pontiac, USA.
Otolaryngology - Head and Neck Surgery, Advanced Ear, Nose & Throat - Head & Neck Surgery, Las Vegas, USA.
Cureus. 2021 Oct 24;13(10):e19012. doi: 10.7759/cureus.19012. eCollection 2021 Oct.
Head and neck osteosarcomas (HNOS) account for less than 1% of all head and neck cancers and makeup 6-10% of all primary osteosarcomas. Mandibular osteosarcomas are the second most common subtype of HNOS. They demonstrate higher recurrence rates; however, are amenable to surgery. An 18-year-old male presented with a 2 cm x 3 cm x 2 cm intraoral mass for two months. Biopsy revealed chondroblastic osteosarcoma. Computed tomography revealed extension into the left internal jugular vein. Composite resection of the left mandible, floor of the mouth, ventral tongue, submandibular gland, and modified radical neck dissection with fibular flap repair was performed. Adjuvant chemotherapy and palliative radiotherapy were added. Unfortunately, progressive metastasis to the contralateral mandible and entire spinal cord ensued. We report the first case of head and neck osteosarcoma with intravascular invasion into the internal jugular vein.
头颈部骨肉瘤（HNOS）占所有头颈部癌症的比例不到1%，占所有原发性骨肉瘤的6%-10%。下颌骨肉瘤是HNOS的第二常见亚型。它们的复发率较高；然而，适合手术治疗。一名18岁男性出现一个2 cm×3 cm×2 cm的口腔内肿物，持续两个月。活检显示为软骨母细胞性骨肉瘤。计算机断层扫描显示肿瘤已延伸至左颈内静脉。对左侧下颌骨、口腔底部、舌腹、下颌下腺进行了联合切除，并进行了改良根治性颈清扫术，同时采用腓骨瓣修复。术后进行了辅助化疗和姑息性放疗。不幸的是，随后出现了对侧下颌骨和整个脊髓的进行性转移。我们报告了首例头颈部骨肉瘤血管内侵犯颈内静脉的病例。
