A Novel Case of Bisphosphonate-Related Osteonecrosis of the Torus Palatinus in a Patient with Metastatic Breast Cancer

Vol. 71, No. 3-4, 2006

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Case Report

A Novel Case of Bisphosphonate-Related Osteonecrosis of the Torus Palatinus in a Patient with Metastatic Breast Cancer
Matthew L. Goldman^a, Neelima Denduluri^a, Arlene W. Berman^a, Rebecca Sausville^a, Jean-Pierre Guadagnini^c, David E. Kleiner^b, Jaime S. Brahim^d, Sandra M. Swain^a

^aBreast Cancer Section, Medical Oncology Branch and
^bLaboratory of Pathology, National Cancer Institute,
^cDental Consult Service and
^dOral and Maxillofacial Surgery, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Md., USA

Address of Corresponding Author

Oncology 2006;71:306-308 (DOI: 10.1159/000106451)

Key Words

Zoledronic acid
Bisphosphonate toxicity
Maxillary exostosis
Jaw osteonecrosis
Torus palatinus

Abstract

Bisphosphonates administered orally and intravenously are used for a variety of endocrine and oncologic indications. Long-term intravenous use of bisphosphonates has been shown to cause osteonecrosis of the jaw. We report a case in which a 58-year-old woman with metastatic breast cancer received 18 doses of 4 mg intravenous zoledronic acid over a period of 16 months and developed a region of osteonecrosis on the posterior edge of a large, lobular torus palatinus. Torus palatinus, a type of maxillary exostosis, is common among postmenopausal women, and is vulnerable to blunt trauma that could predispose to osteonecrosis. Sequestrum of dead bone was removed and the site healed within 4 weeks. This case demonstrates that patients with a torus palatinus may be at high risk for osteonecrosis, and reinforces the need for good oral hygiene and frequent dental examination while receiving bisphosphonate therapy.

Author Contacts

Sandra M. Swain, MD
Breast Cancer Section, Medical Oncology Branch, Centre for Cancer Research
National Cancer Institute, National Institute of Health
8901 Wisconsin Ave, Building 8, Room 5101, Bethesda, MD 20889 (USA)
Tel. +1 301 435 5416, Fax +1 301 496 0047, E-Mail swains@mail.nih.gov

Article Information

Received: September 26, 2006
Accepted after revision: November 18, 2006
Published online: July 26, 2007
Number of Print Pages : 3
Number of Figures : 2, Number of Tables : 0, Number of References : 11

Medline Abstract (ID 17657174)

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