Concurrent Oral Squamous Cell Carcinoma and Bisphosphonate-Related Osteonecrosis of the Maxilla: A Case Report and Literature Review

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-10-28 DOI:10.1002/hed.27974

Michelle Yoon, Ricardo Ramirez, Jun Yun, Christina Wiedmer, Margaret Brandwein-Weber, Azita S. Khorsandi, Daniel Buchbinder, Mohemmed N. Khan

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引用次数: 0

Abstract

Introduction

Bisphosphonates (BPs) are widely used for osteoporosis and cancer-induced bone diseases due to their antiresorptive properties, yet they pose risks such as medication-related osteonecrosis of the jaw (MRONJ).

Methods

We present a unique case of concurrent oral squamous cell carcinoma (SCC) and MRONJ in a 72-year-old female chronically treated with oral ibandronate for osteoporosis. Following a dental extraction, she developed a nonhealing wound in the maxilla. Following conservative treatment, the patient underwent a maxillectomy and extensive tissue reconstructions to control her infection and address suspicions of an underlying malignancy.

Results

Histopathological examinations confirmed simultaneous osteonecrosis and well-differentiated SCC in the maxillary sinus and surrounding tissues. Despite multiple surgeries, the patient's disease progressed rapidly. Upon examining the literature for patients with a history of BP use diagnosed with MRONJ and/or SCC, a total of 16 cases report a diagnostic dilemma between MRONJ and locoregional SCC. Three of the 16 cases report a final diagnosis of concurrent MRONJ and SCC. This report is the fourth reported case of concurrency to date.

Conclusions

The patient's complex clinical course underscores the diagnostic challenges and therapeutic dilemmas in managing concurrent MRONJ and SCC, highlighting the need for vigilant monitoring and interdisciplinary collaboration in similar cases.

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并发口腔鳞状细胞癌和与双膦酸盐相关的上颌骨骨坏死：病例报告和文献综述》（Concurrent Oral Squamous Cell Carcinoma and Bisphosphonate-Related Osteonecrosis of the Maxilla: A Case Report and Literature Review.

导言：双膦酸盐（BPs）因其抗骨吸收特性而被广泛用于治疗骨质疏松症和癌症诱发的骨病，但它们也存在药物相关性颌骨坏死（MRONJ）等风险：我们介绍了一例独特的口腔鳞状细胞癌（SCC）和 MRONJ 并发病例，患者是一名 72 岁的女性，长期口服伊班膦酸钠治疗骨质疏松症。拔牙后，她的上颌骨出现了不愈合的伤口。经过保守治疗后，患者接受了上颌骨切除术和广泛的组织重建术，以控制感染并消除对潜在恶性肿瘤的怀疑：组织病理学检查证实，上颌窦和周围组织中同时存在骨坏死和分化良好的SCC。尽管进行了多次手术，但患者的病情进展迅速。在对有服用 BP 史并被诊断为 MRONJ 和/或 SCC 患者的文献进行研究后，共有 16 个病例报告了 MRONJ 和局部 SCC 之间的诊断难题。16 例病例中有 3 例最终诊断为 MRONJ 和 SCC 并发症。本报告是迄今为止报告的第四例并发症：该患者复杂的临床病程凸显了在处理并发 MRONJ 和 SCC 时所面临的诊断挑战和治疗难题，强调了对类似病例进行警惕性监测和跨学科合作的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.