Periodontal manifestation of osteosarcoma of the fibula: A case report and review of literature

Abstract

Osteosarcoma is a rare and aggressive malignant mesenchymal tumor. It usually presents in the long bones about a decade prior to that in jaws. This clinical condition is characterized by radiolucent to radiopaque masses, sunburst appearance, codman’s triangle and periodontal ligament space widening in the jaws. A male aged thirty years reported to us with chief complaint of severe pain in gums in the lower left back region. Intraoral examination revealed tobacco stains on his teeth   revealing his habit of tobacco chewing and bidi smoking. There was moderate amount of plaque deposition and periodontal pocket ranged from 2 to 5 mm in depth. Orthopantogram revealed widening of periodontal ligament space in the 35, 36, 37, 38 region. The patient also gave history of severe bone pain in left leg for last 3 years and was referred to orthopedic department where he was diagnosed as a case of osteosarcoma of left fibula after various hematological and radiological investigations. Clinical acumen in detecting unusual periodontal ligament widening with no apparent cause as in this case lead to detection of osteosarcoma in  the left fibula after clinical, radiological and histopathological correlation emphasizing the role of inter disciplinary approach.