Fibroblastic osteosarcoma: A perplexing entity

Osteosarcoma (OS), also referred to as osteogenic sarcoma, is the most common primary malignant tumour affecting long bones, characterised by the proliferation of osteoblastic precursor cells and the production of osteoid or immature bone. OSs of the head and neck region have unique biology, exhibiting a clinical behaviour and a natural history that are distinct from OSs of the trunk and extremities. Similarly, their radiological appearance and histological growth pattern can be quite diverse proving to be a challenge to histopathologists to arrive at a diagnosis. Hence, OSs of the jaw remain enigmatic, and a number of difficulties related to their diagnosis and treatment are yet to be resolved. This article reports on a case of advanced OS of the mandible in a 45-year-old woman who came for the evaluation of swelling. This case illustrates the various modalities of diagnosis, such as radiology, histopathology and immunohistochemistry for the confirmation of the variants of OS, leading to an enormously improved quality of life by offering an improved opportunity for cure and treatment.