Kanno Naomi I, Ito Takashi, Takaoka Shohei, Yamagata Kenji, Bukawa Hiroki
Oral and Maxillofacial Surgery, University of Tsukuba, Institute of Medicine, Ibaraki, JPN.
Cureus. 2024 May 28;16(5):e61280. doi: 10.7759/cureus.61280. eCollection 2024 May.
This study presents a rare case of an Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) co-existing with medication-related osteonecrosis of the jaw (MRONJ) in the mandible of a 54-year-old Japanese man who complained of painful swelling of the left mandibular gingiva over the past three months. The patient had a history of methotrexate (MTX) and bisphosphonates (BPs) use. Intraoral examination revealed a 35 mm large ulcerative lesion with marginal gingival swelling and bone exposure on the left side of the mandible. A biopsy was performed, confirming the diagnosis of EBVMCU with MRONJ. Due to the enlargement of the bone exposure, marginal resection of the mandible was performed under general anesthesia as a treatment for residual MRONJ. At the two-year follow-up, no evidence of recurrence was observed.
本研究报告了一例罕见病例，一名54岁日本男性下颌骨出现爱泼斯坦-巴尔病毒阳性黏膜皮肤溃疡（EBVMCU）并伴有药物相关性颌骨坏死（MRONJ），该患者在过去三个月中一直抱怨左下颌牙龈疼痛肿胀。患者有使用甲氨蝶呤（MTX）和双膦酸盐（BP）的病史。口腔检查发现下颌骨左侧有一个35毫米大的溃疡性病变，伴有边缘牙龈肿胀和骨质暴露。进行了活检，确诊为EBVMCU合并MRONJ。由于骨质暴露扩大，在全身麻醉下对下颌骨进行了边缘切除，作为残留MRONJ的治疗方法。在两年的随访中，未观察到复发迹象。
