Uncommon presentation of medication-related osteonecrosis of the mandible in a patient with metastatic prostate cancer

An 82-year-old man with a background of prostate carcinoma and bony metastases presented with bilateral discharging neck fistulae. Two years prior to presentation, the patient had been treated with intravenous zoledronic acid for 1 year as part of chemotherapy. Intraoral examination revealed extensi...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2019-02, Vol.12 (2), p.e228238
Main Authors: Thavarajah, Meera, Jayaram, Rahul
Format: Article
Language:English
Subjects:
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Antibiotics
Bone Density Conservation Agents - adverse effects
Cancer therapies
Case reports
Fistula
Free Radical Scavengers - therapeutic use
Humans
Infections
Jaw
Male
Mandible - pathology
Maxillofacial surgery
Metastasis
Osteonecrosis - chemically induced
Osteonecrosis - drug therapy
Osteoporosis
Patients
Pentoxifylline - therapeutic use
Prostate cancer
Prostatic Neoplasms - drug therapy
Prostatic Neoplasms - pathology
Surgeons
Unusual Presentation of More Common Disease/Injury
Vitamin E - therapeutic use
Zoledronic Acid - adverse effects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:An 82-year-old man with a background of prostate carcinoma and bony metastases presented with bilateral discharging neck fistulae. Two years prior to presentation, the patient had been treated with intravenous zoledronic acid for 1 year as part of chemotherapy. Intraoral examination revealed extensive bilateral medication-related osteonecrosis, with orocutaneous fistulae within the neck. Treatment comprised removal of loose necrotic bone sequestrae, debridement of the fistulae and long-term administration of antibiotics, vitamin E and pentoxifylline. Four weeks later, the orocutaneous fistulae had healed.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-228238