累及颧骨的上颌骨药物相关性骨坏死：一例报告。
Medication-related osteonecrosis of the upper jaw involving the zygomatic bone: A case report.
作者信息
Otsuru Mitsunobu, Soutome Sakiko, Hayashida Saki, Morishita Kota, Yanamoto Souichi, Umeda Masahiro
机构信息
Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki-shi, Nagasaki-ken 852-8588, Japan.
Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki-shi, Nagasaki-ken 852-8588, Japan.
出版信息
Int J Surg Case Rep. 2023 Mar;104:107932. doi: 10.1016/j.ijscr.2023.107932. Epub 2023 Feb 17.
INTRODUCTION AND IMPORTANCE
Osteonecrosis of the jaw resulting from treatment with antiresorptive agents, such as bisphosphonates and denosumab, is widely recognized as medication-related osteonecrosis of the jaw (MRONJ). However, to the best of our knowledge, there are no reports of medication-related osteonecrosis of the upper jaw extending to the zygomatic bone.
CASE PRESENTATION
An 81-year-old woman treated with denosumab for multiple lung cancer bone metastases presented to the authors' hospital with a swelling in the upper jaw. Computed tomography showed osteolysis, periosteal reaction of the maxillary bone, maxillary sinusitis, and osteosclerosis of the zygomatic bone. The patient underwent conservative treatment; however, osteosclerosis of the zygomatic bone progressed to osteolysis.
CLINICAL DISCUSSION
If the maxillary MRONJ extends to the surrounding bony structures, such as the orbit and skull base, serious complications may occur.
CONCLUSION
It is important to detect early signs of maxillary MRONJ, before it involves the surrounding bones.
引言与重要性
由抗吸收剂（如双膦酸盐和地诺单抗）治疗导致的颌骨骨坏死被广泛认为是药物相关性颌骨骨坏死（MRONJ）。然而，据我们所知，尚无上颌骨药物相关性骨坏死扩展至颧骨的报道。
病例介绍
一名81岁女性因多发性肺癌骨转移接受地诺单抗治疗，因上颌肿胀就诊于作者所在医院。计算机断层扫描显示骨质溶解、上颌骨骨膜反应、上颌窦炎以及颧骨骨硬化。患者接受了保守治疗；然而，颧骨骨硬化进展为骨质溶解。
临床讨论
如果上颌MRONJ扩展至周围骨结构，如眼眶和颅底，可能会发生严重并发症。
结论
在涉及周围骨骼之前早期发现上颌MRONJ的迹象很重要。
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