Objective: This paper reports a case of mandibular ramus parosteal osteosarcoma, discussing diagnostic problems and reviewing treatment variations.

Methods: A 37 year old male patient was referred by a private hospital with a history of abscesses treatment and removal of his right lower molar 1.5 years ago. The wound in his tooth socket was not healed. Swelling with abscesses recurred and was diagnosed as osteomyelitis. The Orthopantomogram (OPG) result showed a description of osteomyelitis, and the Multi Slice Computed Tomography (MSCT) 3D confirmed the suspected osteosarcoma. Histopathologic results indicated parosteal osteosarcoma. 

Result: Hemimandibulectomy and chemotherapy were performed with good results.

Conclusion: This parosteal osteosarcoma was difficult to diagnosis quickly because the initial image resembled osteomyelitis but it was low grade and rare; therefore, meticulous and accurate diagnosis was deemed necessary. Chemotherapy-combined surgery was thereby performed for treating this parosteal osteosarcoma.

Balwani SR, Tupkari JV, Barpande S. Parosteal osteosarkoma of the mandibula. J Oral Maxillofacial Pathol 2006;10: 10-14.

Diniz AF, Filho JAA, Alencer RC, etal. Low-grade central osteosarcoma of the mandible: a case study report. Oral Surg, Oral Med, Oral Pathol, Oral Radiol and Endodontol 2007;103: 246-252.

Nanci NF, Marchiori E, Vianna AD, et al. Osteossarcoma parosteal: aspectos na radiologia convencional TT-Parosteal osteosarcoma: conventional radiology findings. Radiol Bras 2007;40: 81-86.

Chakravarthi PS, Vivekanand S, Kattimani VS, et al. Juxtacortical osteosarcoma of the mandible: challenges in diagnosis and management. National J Maxillofac Surg 2015;6: 127-131.

Kaur H, Singh A. Osteosarcoma of jaw-Case report and review of literature. IJMDS 2015;4: 653-657.

Bojan A, Christy W, Chanmougananda S, et al. Osteosarcoma of mandible : a case report and review of literature. J Clin Diagnostic Res 2012;6: 753-757.

Bhatia V, Sharma S, Sood RG, etal. Bony beard: osteosarcoma of the mandible with exuberant sunburst periosteal reaction. Int J Med Biomed Res 2012;1: 85-88.

Huang TC, Monsour PA, Chahoud CD. Parosteal osteosarcoma: report of a case and review of the literature. Aust Dent J 2010;55: 86-91.

Hang JF, Chen PCH. Parosteal osteosarcoma. Arch Pathol Lab Med 2014;138: 694-699.

Singh S, Sangwan M, Verma R, etal. Case report: parosteal osteosarcoma of wrist: a rare case report. Int J Healthcare & Biomed Res 2014;2: 60-62.

Anil S, Krishnan AP, Rajendran R. Osteosarcoma of the mandible masquerading as a dental abscess: report of a case. Case Rep Dent 2012;1: 1-5.

Malik NA. Textbook of oral and maxillofacial surgery, 3rded. New delhi: Jaype Brother Medical Publisher; 2012. p. 713-740.

Henry CJ, Stassen LF. The non-healing extraction socket: a diagnostic dilemma-case report and discussion. Irish Dental Assocation (IDA) 2016;62: 215-220.

Bansal D, Grewal HK, Jawanda M, etal. A rare site of adenocarcinoma not otherwise specified: a case report. Indian J Stomatol 2012;3: 282-285.

Lakshman AR, Kanneppady SK. An unusual case of primary intraosseous carcinoma of the mandible. J Dentofac Sci 2013;2: 5-8.

Kalburge JV, Sunil K, Sahuji SK, et al. Osteosarcoma of mandible. J Clin Diagnostic Res 2012;6: 1597-1599.

Lokesh K, Kannabiran J, Eregowda S. Maxillary ewing′s sarcoma: a report of innocuous lesion with nocuous pathology. J Indian Academy Oral Med & Radiol 2016;28: 203-206.

Petrikowski CG, Pharoah MJ, Lee L, et al. Radiographic differentiation of osteogenic sarcoma, osteomyelitis and fibrous dysplasia of the jaws. Oral Surg, Oral Med, Oral Pathol and Oral Radiol 1995;80: 744-750.

Khorate MM, Goel S, Singh MP, et al. Osteosarcoma of mandible: a case report and review of literature. J Cancer Sci & Therapy 2010;2: 122-125.

Athar M. Malignant mandibular tumors : two case reports of rare mandibular tumors in a single institution. Arch Med Biomed Res 2014;1: 22-29.

IsmardianitaE,NasrulE,Yanwirasti,etal.Effect of ethanol extract of myrmecodia pendens on TGF-β1 expression and osteoblast cells after tooth extraction (experimental research on cavia cobaya). J Dentomaxillofac Sci 2017;2: 150-154.