Matsuda Shinpei, Yoshida Hisato, Shimada Minako, Yoshimura Hitoshi
Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Medicine (Baltimore). 2020 Aug 14;99(33):e21756. doi: 10.1097/MD.0000000000021756.
Medication-related osteonecrosis of the jaw decreases quality of life of patients with cancer. The debate about it continues regarding the risk factors, etiology, and treatment methods, and so on. Also, spontaneous regeneration of the mandible is clinically rare.
A 67-year-old woman presented to the authors' department complaining of pain, swelling, and pus discharge from a fistula. She previously had breast cancer bone metastases and had received antiresorptive intravenous bisphosphonate.
The patient was diagnosed with medication-related osteonecrosis of the jaw.
She received conservative therapy with antibiotics and surgical therapy as sequestrectomy under general anesthesia; however, the lesion did not heal. Thirty months after the MRONJ diagnosis, when she was 70 years' old, she underwent a left hemimandibulectomy without reconstruction under general anesthesia.
Spontaneous regeneration of the mandible was observed by follow-up imaging examinations. The patient has no current subjective or objective symptoms.
This is the first case report of the spontaneous mandibular regeneration after surgery for medication-related osteonecrosis of the jaw. Additionally, this case was the oldest patient among the published mandibular regeneration cases.
药物相关性颌骨坏死会降低癌症患者的生活质量。关于其危险因素、病因及治疗方法等的争论仍在继续。此外，下颌骨的自发再生在临床上较为罕见。
一名67岁女性因瘘管处疼痛、肿胀及脓性分泌物就诊于作者所在科室。她曾患有乳腺癌骨转移，并接受过抗吸收静脉注射双膦酸盐治疗。
该患者被诊断为药物相关性颌骨坏死。
她接受了抗生素保守治疗及全身麻醉下的死骨切除术等手术治疗；然而，病变未愈合。在药物相关性颌骨坏死诊断30个月后，即她70岁时，接受了全身麻醉下的左侧半下颌骨切除术且未进行重建。
通过随访影像学检查观察到下颌骨自发再生。患者目前无主观或客观症状。
这是首例药物相关性颌骨坏死手术后下颌骨自发再生的病例报告。此外，该病例是已发表的下颌骨再生病例中年龄最大的患者。
