Pamidronic acid/zoledronic acid
- PDF / 143,029 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 12 Downloads / 248 Views
S
1
Chaturvedi P, et al. Bisphosphonate induced osteonecrosis of the jaw masquerading as tumor: a word of caution for oral surgeons and oncologists. European Journal of Surgical Oncology 36: 541-5, No. 6, Jun 2010 - India 803033814
Osteonecrosis of the jaw: 5 case reports Five patients developed osteonecrosis of the jaw (ONJ) during treatment with the bisphosphonates zoledronic acid or pamidronic acid. A 56-year-old woman presented with right submandibular swelling, erythema and purulent discharge. She had a history of metastatic breast cancer, and had been receiving monthly IV zoledronic acid 4mg for 9 months. An orthopantomogram and CT scan revealed a large lytic area within the horizontal ramus of her right mandible. ONJ was suspected following bone biopsy, and zoledronic acid was stopped. Swelling and bone exposure persisted during 3 months of follow-up. A 76-year-old man with multiple myeloma presented with painful pre-maxillary bone exposure after 14 months of therapy with monthly IV zoledronic acid 4mg. He had undergone two unsuccessful biopsies after which the pain had increased, and he had developed a painful ulcer near the biopsy site. He was treated with systemic antibiotics and antimicrobial mouth washes, but bone exposure persisted after 2 weeks. A CT scan was diagnostic for bisphosphonate-induced ONJ, zoledronic acid was withdrawn, and he underwent sequestrectomy. At followup 16 months later, he had remained asymptomatic apart from palatal perforation. A 52-year-old man with metastatic prostate cancer presented with toothache in the molar area. He had received monthly IV zoledronic acid 4mg for 6 months, and his therapy had been switched to an oral bisphosphonate 13 months earlier [drug and dosage not specified]. His painful tooth was extracted, but his pain subsequently deteriorated despite antibiotic therapy; a purulent discharge persisted, and large soft tissue swelling developed in the adjacent area. An x-ray revealed a large lytic area in the vicinity of the extraction socket. A bone biopsy was indicative of ONJ. He was treated with antibiotics, mouth washes and pain killers, and his lesion resolved after 4 months. A 76-year-old woman presented with a 3-month history of progressive left jaw pain and swelling, which had begun after extraction of her left second molar. She had a history of breast cancer with bone metastases, treated with IV pamidronic acid during the first year and IV zoledronic acid during the second year [dosages and times to onset not stated]; her therapy had been changed to oral bisphosphonates 6 months before tooth extraction [drug and dosage not specified]. Needle aspiration and biopsy were diagnostic for ONJ [outcome not stated]. A 68-year-old man with multiple myeloma presented with painless swelling of his right jaw. He had undergone tooth extraction almost 28 months after initiation of monthly IV zoledronic acid 4mg, and had developed swelling at and around the extraction sites almost 5 months later. A CT scan revealed thinning cortices and destruction of the adjoining
Data Loading...
