Publications

Authors:

Bedogni, Alberto; G., Saia; M., Ragazzo; G., Bettini; Capelli, Paola; E., D'Alessandro; Nocini, Pier Francesco; L., Lo Russo; L., Lo Muzio; S., Blandamura

Title:

Bisphosphonate-associated osteonecrosis can hide jaw metastases

Year:

2007

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Format:

A Stampa

Referee:

Sì

Name of journal:

Bone

ISSN of journal:

8756-3282

Page numbers:

942-945

Keyword:

Bisphosphonate; Osteonecrosis; Metastasis; Jawbone; Osteomyelitis

Short description of contents:

Background: Osteonecrosis of the jaw is a well known potential complication of bisphosphonate treatment but its pathogenesis is poorly understood. The current management of patients with bisphosphonate-associated osteonecrosis (BON) is based on “expert recommendations” and there is a recognized need of better evidence. We report two cases where BON hid jaw metastases and use them to discuss some limitations of the current recommendations. Patients: Two patients undergoing long-term I.V. amino-bisphosphonate treatment for metastatic cancer presented with areas of intraorally exposed jawbone. Bisphosphonate-associated osteonecrosis was diagnosed on the basis of medical history, clinical and radiological features. They underwent surgical resection of the affected jaw due to unrelenting pain and lack of response to conservative treatments. Results: Histological examination of the surgical specimen revealed cancer cells at the margins of the site of osteonecrosis. Our patients did not undergo bone biopsy according to current recommendations, due to lack of clinical and radiological signs suggestive of jaw metastases. Conclusions: Our findings show that: i) patients with BON may also have jaw metastases; ii) there may not be clinical or imaging hints to this fact and; iii) that a biopsy based on careful selection of the site (with inclusion of necrotic margins) may be needed to reach the correct diagnosis. Further studies should be performed on this topic because of its very important prognostic implications.

Product ID:

45798

Handle IRIS:

11562/312999

Deposited On:

October 24, 2007

Last Modified:

November 15, 2022

Bibliographic citation:

Bedogni, Alberto; G., Saia; M., Ragazzo; G., Bettini; Capelli, Paola; E., D'Alessandro; Nocini, Pier Francesco; L., Lo Russo; L., Lo Muzio; S., Blandamura, Bisphosphonate-associated osteonecrosis can hide jaw metastases «Bone» , 2007 , pp. 942-945

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