Open AccessChallenge in Diagnosis and Management of Simultaneous Multiple Myeloma Bone Lesion and Medication-Related Osteonecrosis of the Jaw
Author(s) -
Dhekra Jlassi,
Nour Saida Ben Messaoud,
Ghada Bouslama,
Aya Mtiri,
Souha Ben Youssef,
Abdellatif Boughzela
Publication year - 2021
Publication title -
sas journal of surgery
Language(s) - English
Resource type - Journals
ISSN - 2454-5104
DOI - 10.36347/sasjs.2021.v07i11.011
Subject(s) - denosumab , osteonecrosis of the jaw , medicine , pathognomonic , zoledronic acid , multiple myeloma , bisphosphonate , bone metastasis , bisphosphonate associated osteonecrosis of the jaw , bone density conservation agents , radiology , surgery , metastasis , osteoporosis , pathology , cancer , disease , bone density
Medication-related osteonecrosis of the jaw (MRONJ) is a well-known complication of antiresorptive treatments and was first described with bisphosphonate treatment and recently with denosumab, and other anti-angiogenic drugs. It has been reported that MM patients have the highest risk of MRONJ mainly in patients who received combination of pamidronate and zoledronate. Neither clinical nor radiologic features are pathognomonic for MRONJ, in fact bone metastasis may have overlapping characteristics and must be excluded in histologic examination. We report a case of a multiple myeloma patient treated with zoledronic acid and whose initial clinical presentation was challenging to distinguish between bone metastasis and MRONJ.