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

Abstract

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. 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. If the maxillary MRONJ extends to the surrounding bony structures, such as the orbit and skull base, serious complications may occur. It is important to detect early signs of maxillary MRONJ, before it involves the surrounding bones.