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Osteonecrosis of the jaw manifested as cervical abscess: case report A 65-year-old woman developed osteonecrosis of the jaw manifested as cervical abscess during treatment with zoledronic acid for breast carcinoma. The woman was diagnosed with active periodontal disease in 2013. She also had stage 4 advanced breast carcinoma for which, she underwent axillary dissection and lumpectomy followed by polychemotherapy and radiotherapy. In 2014, bone scintigraphy revealed metastatic foci in the right wing of the sacrum and spine with symptoms of severe pain. Therefore, further treatment was started with IV zoledronic acid [Zometa] 4mg every 3 weeks. In 2015, she presented with right sub-mandibular abscess, which was drained under local anaesthesia. During the procedure, 150mL of purulent, caseous material was obtained and culture studies revealed presence of Actinomyces israelii. The woman was hospitalised and treated with broad spectrum antibiotic therapy. The radiographic studies including a CT scan demonstrated a large area of osteonecrosis in the region of the right half of the jaw. Thus, she was prescribed amoxicillin and chlorhexidine and after a week, extensive curettage of the lesion was performed under general anaesthesia. This resulted in favourable evolution of the osteonecrosis of the jaw. However, in February 2017, she died of underlying breast carcinoma. Sanchez Lopez JD, et al. Cervical abscess as an exceptional presentation of advance bisphosphonate-related osteonecrosis of the jaw: Case report and review of the literature. Reumatologia Clinica 16: 250-251, No. 3, May-Jun 2020. Available from: URL: http://doi.org/10.1016/j.reuma.2018.03.002 [Spanish; summarised from a 803500812 translation]

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Reactions 12 Sep 2020 No. 1821