MAXILLOFACIAL OSTEOSARCOMA AND MOLECULAR BIOMARKERS: ADVANCES IN EARLY DIAGNOSIS, CLINICAL, RADIOGRAPHIC, HISTOPATHOLOGICAL AND THERAPEUTIC ASPECTS — A LITERATURE REVIEW

Abstract

 Maxillofacial osteosarcoma is a rare and biologically heterogeneous malignant bone neoplasm characterized by the production of osteoid matrix by malignant cells and significant diagnostic complexity. Although it represents a small proportion of osteosarcomas, tumors affecting the maxilla and mandible present clinical, radiographic, and biological characteristics that may differ from those observed in long bones. Nonspecific clinical manifestations may contribute to diagnostic delays, emphasizing the importance of integrating clinical examination, imaging methods, histopathological evaluation, and molecular investigation. In this context, molecular biomarkers have emerged as promising complementary tools for identifying alterations associated with tumor development, progression, invasion, metastasis, prognosis, and therapeutic response. Among the biomarkers investigated are alterations involving genes related to cell-cycle regulation and DNA repair, as well as microRNAs, circular RNAs, proteins, and circulating tumor-derived molecules. Recent studies suggest that these biomarkers may contribute to risk stratification, prognostic assessment, and disease monitoring. However, their clinical application remains limited by tumor heterogeneity, the small number of studies specifically addressing maxillofacial osteosarcoma, and the lack of standardized validation protocols. Therefore, this literature review aims to analyze the main clinical, radiographic, histopathological, and therapeutic aspects of maxillofacial osteosarcoma, emphasizing current evidence regarding molecular biomarkers and their potential contribution to early diagnosis, prognostic assessment, and the development of individualized therapeutic strategies.