Medication-related osteonecrosis of the upper jaw involving the zygomatic bone: A case report

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.

Automated summary

This article describes a case of medication-related osteonecrosis of the jaw (MRONJ) caused by antiresorptive agents. The case involves an elderly woman with multiple lung cancer bone metastases who developed upper jaw swelling extending to the zygomatic bone. The study highlights the importance of detecting early signs of maxillary MRONJ before it involves surrounding bones.