J Korean Endocr Soc.  2008 Jun;23(3):210-214. 10.3803/jkes.2008.23.3.210.

A Case of Intravenous Pamidronate-Related Osteonecrosis of the Jaw in a Patient with Waldenstrom's Macroglobulinemia

• Lee DM
• Ann MS
• Kim TH
• Park TJ
• Chung YS
• Park JS
• Song SI
• Lee KB
• Joo HJ

• KMID: 1479209
• DOI: http://doi.org/10.3803/jkes.2008.23.3.210

Abstract

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare, but serious, side effect of bisphosphonate therapy that produces significant morbidity in affected patients. It is characterized by poor wound healing and spontaneous intra-oral soft tissue breakdown, which lead to exposure of necrotic maxillary and mandibular bone.

Keyword

pamidronate; osteonecrosis; mandible

MeSH Terms

Bisphosphonate-Associated Osteonecrosis of the Jaw
Diphosphonates
Humans
Jaw
Mandible
Osteonecrosis
Waldenstrom Macroglobulinemia
Wound Healing
Diphosphonates

Figure

• 

  Fig. 1 A dental panoramic view demonstrated osseous sclerosis of alveolar bone in both sides of mandible. Mandibular canals were accentuated by surrounding osseous sclerosis.

• 

  Fig. 2 A whole body bone scan showed focal increased uptake in left mandible suggesting dental problem. Diffuse increased uptake in both patella and both shoulder joints suggesting probably arthritic change.

• 

  Fig. 3 Sections of bone showed chronic osteomyelitis associated with dead bone with empty lacunae, bone resorption, and fat necrosis in the marrow space (H&E stain, ×100).

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