A case of methotrexate-associated lymphoproliferative disorder accompanied by osteonecrosis of the maxilla

Intraoral localized methotrexate‐associated lymphoproliferative disorders concurrent with antiresorptive agent‐related osteonecrosis of the jaw: A case report and literature review

“…Intraoral localized MTX‐LPD was considered to show good prognosis after drug withdrawal, with or without bone exposure. In three cases of no remission after withdrawal of MTX, chemotherapy was performed 2,23,30 . Two of the three cases showed systemic symptoms, 2,23 and in one case, a fistula was detected in the palatal opening in the naso‐genian region 30 .…”

“…A review of the literature revealed 22 cases of intraoral localized MTX-LPD with bone exposure, including our case (Table 1). 2,3,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] The mean age of the patients was 73 years (range, 44-92 years), and the male to female ratio was 2:1. The mean duration of MTX treatment was 8.6 years (range, 0.6-20 years).…”

“…In three cases of no remission after withdrawal of MTX, chemotherapy was performed 2,23,30 . Two of the three cases showed systemic symptoms, 2,23 and in one case, a fistula was detected in the palatal opening in the naso‐genian region 30 . It was considered that the presence of extraoral symptoms had an influence on the prognosis of intraoral localized MTX‐LPD.…”

“…Most intraoral localized MTX‐LPD patients (20/22) were Japanese 3,20‐30,33,35 . However, the reason is unclear.…”

“…Most intraoral localized MTX-LPD patients (20/22) were Japanese. 3,[20][21][22][23][24][25][26][27][28][29][30]33,35 However, the reason is unclear. Therefore, a study has been initiated jointly by three academic societies (Japan College of Rheumatology, The Japanese Society of Hematology, The Japanese Society of Pathology) in Japan.…”