Imaging Sci Dent.  2023 Sep;53(3):247-256. 10.5624/isd.20220223.

Importance of 3-dimensional imaging in the early diagnosis of chondroblastic osteosarcoma

• Cuschieri LA
• Schembri-Higgans R
• Bezzina N
• Betts A
• Cortes ARG

• KMID: 2546698
• DOI: http://doi.org/10.5624/isd.20220223

Abstract

The aim of this report is to present a case of chondroblastic osteosarcoma located in the right maxillary premolar region of a 17-year-old female patient. The initial clinical presentation and 2-dimensional (2D) radiographic methods proved inadequate for a definitive diagnosis. However, a cone-beam computed tomography scan revealed a hyperdense, heterogeneous lesion in the right maxillary premolar region, exhibiting a characteristic “sun-ray” appearance. To assess soft tissue involvement, a medical computed tomography scan was subsequently conducted. A positron emission tomography scan detected no metastasis or indications of secondary tumors. T1- and T2-weighted magnetic resonance imaging showed signal heterogeneity within the lesion, including areas of low signal intensity at the periphery. Histological examination conducted after an incisional biopsy confirmed the diagnosis of high-grade chondroblastic osteosarcoma. The patient was then referred to an oncology department for chemotherapy before surgery. In conclusion, these findings suggest that early diagnosis using 3-dimensional imaging can detect chondroblastic osteosarcoma in its early stages, such as before metastasis occurs, thereby improving the patient’s prognosis.

Keyword

Osteosarcoma; Cone-Beam Computed Tomography; Diagnostic Imaging; Radiography