Mehmet YÜKSEL, Bilal GUMUS, Serkan BORAZAN, Talha MUEZZİNOGLU

A rare complication of prolonged bisphosphonate treatment: The osteonecrosis of jaw in a patient with metastatic prostate cancer

Bisphosphonates are frequently used for the treatment of bone metastases. We described a 71 years old male with the previous diagnosis of bone metastatic prostate cancer and who underwent hormonotherapy combined with zolendronic acid treatment during 7.5 years and presented the complaints of severe jaw pain and inability of chewing. It was determined that the findings of increased PSA with osteonecrotic area on jaw at radiological imaging. He was urgently diagnosed with the diagnosis of osteonecrosis of jaw related to the long-term zolendronic acid treatment. Bisphosphonate treatment was stopped, and he was treated with conservative treatment, and the disorder was improved by this management. This unclear disorder is required more detailed studies on the terms of ethiology, treatment style, follow-up at the treatment period, and management of complications with the aim of applying these agents more safely.

Keywords:

Prostate cancer, bone metastasis, Bisphosphonate treatment, jaw osteonecrosis,

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Carter G, Goss AN, Doecke C. Bisphosphonates and avascular necrosis of the jaw: a possible association. Med J Aust 2005; 182: 413-415.
Drake MT, Clarke BL, Khosla S. Bisphosphonates: mechanism of action in clinical practise. Mayo Clin Proc 2008; 83: 1032-1045.
Greenberg MS. Intravenous bisphosphonates and osteonecrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98: 259-260.
Capsoni F, Longhi M, Weinstein R. Bisphosphonateassociated osteonecrosis of the jaw: the rheumatologist’s role. Arthritis Res Ther 2006; 8: 219-2
Conte P, Guarneri V. Safety of intravenous and oral bisphosphonates and compliance with dosing regimens. Oncologist 2004; 9: 28-37.
Markiewicz MR, Marggarone JE, Campbell JH, Aguirre A. Bisphosphonate associated osteonecrosis of the jaws: a review of current knowledge. J Am Dent Assoc 2005; 136: 1669-1674.
Green JR. Antitumor effects of bisphosphonates: Cancer 2003; 97: 840-847.
Santini D, Vincenzi B, Avvisati G et al. Pamidronate induces modifications of circulating antigenetic factors in cancer patients. Clin Cancer Res 2002; 8: 1080-1084.
Santini D, Vespasiani Gentilucci U, Vincenzi B et al. The antineoplastic role of bisphosphonates: from basic research to clinical evidence. Ann Oncol 2003; 14: 1468-1476.
Clezardin P. The antitumor potential of bisphosphonates. Semin Oncol 2002; 6: 33-42.
Delmas PD. The use of bisphosphonates in the treatment of osteoporosis. Curr Opin Rheumatol 2005; 17: 462-466.
Schwartz HC, Kagan AR. Osteoradionecrosis of the mandible. Am J Clin Oncol 2002; 25: 168-171.
Bouquot JE, McMahon RE. Neuropathic pain in maxillofacial osteonecrosis. J Oral Maxillofac Surg 2000; 58: 1003-1020.
Assael LA. New foundations in understanding osteonecrosis of the jaws. J Oral Maxillofac Surg 2004; 62: 125-156.
Advisory Task Force on Bisphosphonate-Related Osteonecrosis of the Jaws, American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg 2007; 65: 369-376.