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

Abstract

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.

Risk Factors for Bisphosphonate-Related Osteonecrosis of the Jaws in Bone Metastatic Breast and Prostate Cancer under Zoledronate Treatment: A Retrospective Analysis from 10 Years of Evaluation

“…This difference in prevalence is related to the different study designs, therapy protocols implemented, and exposure to risk factors. For example, in the study by Taylor et al, (2013) (Taylor et al, 2013) all patients underwent the process of exodontia, which increases the risk of BRONJ.…”