Bevacizumab-associated osteonecrosis of the femur and tibia

Abstract Osteonecrosis is a multifactorial process that can affect different skeletal structures of the body. Osteonecrosis of the jaw associated with bevacizumab, steroids and bisphosphonates, alone or in combination, is a well-documented phenomenon. There are few cases of involvement of the append...

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Bibliographic Details
Published in:Oxford Medical Case Reports 2019-05, Vol.2019 (5), p.omz040
Main Authors: Oliveira, Leandro J C, Canedo, Felipe S N A, Sacardo, Karina P, Alessi, João V M, Barbosa, Felipe G, Shimada, Andrea K, Katz, Artur
Format: Article
Language:English
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Case Report
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Summary:Abstract Osteonecrosis is a multifactorial process that can affect different skeletal structures of the body. Osteonecrosis of the jaw associated with bevacizumab, steroids and bisphosphonates, alone or in combination, is a well-documented phenomenon. There are few cases of involvement of the appendicular skeleton. Magnetic resonance imaging is the most sensitive method for diagnosis. We hereby report two cases of osteonecrosis in the right tibia and in bilateral femoral heads in patients with adenocarcinoma of the lung and ovarian papillary serous carcinoma, respectively, that developed the complication after long-term bevacizumab exposure. Long-term exposure to antiangiogenic treatment may be a potential risk factor. Oncologists should be aware that osteonecrosis is a rare but real toxicity associated with bevacizumab and other antiangiogenics, which can occur in locations different from the jaw.
ISSN:2053-8855
2053-8855
DOI:10.1093/omcr/omz040