Osteosarcoma of H&N

Osteosarcoma of H&N

H. Ric Harnsberger, MD

(Left) Coronal graphic shows right mandible osteosarcoma. Note associated soft tissue mass image with aggressive periosteal reaction image. (Right) Axial bone CT demonstrates large, dense mass arising from the right mandibular body. The mass has both osteoid matrix image and periosteal reaction image associated with it. This is a classic aggressive periosteal reaction associated with osteosarcoma where periosteum is lifted off perpendicular to bone. Marrow within the involved portion of the mandible is sclerotic image.

(Left) Coronal T1 C+ fat-saturated MR reveals a large, heterogeneously enhancing maxillary mass involving the alveolar ridge image, orbital floor image, and deep soft tissues of the cheek image. (Right) Coronal bone CT in the same patient shows extensive new bone formation in the matrix, which creates central low signal. The tumor is centered on the lateral wall of the right maxillary sinus image, extending into the fat pad image and nasal cavity image. Most maxillary OSa are found in the alveolar ridge, not the lateral wall as in this case.



  • Osteosarcoma of head & neck (OSa H&N)


  • Osteogenic sarcoma


  • Malignant tumor arising from bone with ability of neoplastic cells to produce osteoid


General Features

  • Best diagnostic clue

    • H&N bone tumor demonstrating tumor matrix mineralization with aggressive bone destruction and soft tissue extension leads directly to radiologic diagnosis of osteosarcoma

  • Location

    • Mandible ≈ maxilla > > calvarium/skull base

      • All other sites are extremely rare

        • Hard palate, mastoid, zygoma, paranasal sinuses

      • Mandible OSa in mandibular body

      • Maxillary bone OSa in alveolar ridge

    • Postradiation OSa: Typically at border of radiation field

      • Most commonly involves multiple bones at this site

  • Size

Sep 20, 2016 | Posted by in HEAD & NECK IMAGING | Comments Off on Osteosarcoma of H&N
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