Oral mucosal pseudotumor – Novelty complication in patient undergoing bevacizumab therapy

• Published in: Oral oncology 2021-11, Vol.122, p.105543, Article 105543
• Main Authors: Kudva, Adarsh, Koshy, Jonathan, Jacob, Joanna Grace
• Format: Article
• Language: English
• Subjects: Bevacizumab; Bevacizumab - adverse effects; Bevacizumab - therapeutic use; Cholangiocarcinoma - drug therapy; Humans; Jaw Diseases - chemically induced; Male; Middle Aged; MRONJ (medication related osteonecrosis of the jaw); Mucosal pseudotumor; Osteonecrosis; Osteonecrosis - chemically induced; Vascular Endothelial Growth Factor A - antagonists & inhibitors
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2021.105543

•Delayed socket healing, osteosclerosis, exposed bone, mucosal pseudotumor.•Symptomatic treatment with warm saline water and Chlorhexidine gluconate 1 %w/w gel.•Bevacizumab may present a source of osteonecrosis of the jaw (MRONJ) Medication-related osteonecrosis of the jaw (MRONJ) is a manifestation of bone exposure in the maxillofacial region due to use of drugs such as bisphosphonates, anti-resorptive agents and anti-angiogenic agents. This G1- humanized monoclonal antibody neutralizes the activity of the Vascular Endothelial Growth Factor (VEGF), thus reducing the vascularity of the tumor, which in turn, results in the inhibition of its growth. This case report is of a 53-year-old man with metastatic cholangiocarcinoma who received bevacizumab therapy for the past 11 months. Delayed healing of extraction sockets, osteosclerosis, and exposed bone in the mandible with a mucosal swelling was noted a month after extractions were done. The present case reinforces recent observations that the anti-angiogenic properties of bevacizumab may present a source of osteonecrosis of the jaw. To reduce the incidences of MRONJ, it is imperative to emphasize on preventive dental care, strict oral hygiene maintenance, and regular dental follow ups.