Osteonecrosis espontánea de torus mandibulares en un paciente varón con cáncer de mama

Abstract

A 54-year-old male patient with a history of a cerebrovascular accident 10 years ago with residual hemiparesis and dyslipidemia, smoker of 10 cigarettes per day, in treatment with clopidrogel, simvastatin, and captopril. He was diagnosed in 2014 with a retroareolar tumor of about 5.5 cm and right axillary adenopathic block. Histopathologically, a carcinoma was confirmed, immunohistochemical subtype B / HER2 negative and staging CDI cT4N1M0. Treatment was initiated by mastectomy and chemotherapy with taxanes and anthracyclines. In 2017 a thoracic-abdominopelvic tomography was performed and abdominopelvic adenomegalies and L5 body mass were confirmed and at least 4 pulmonary nodules. Treatment was started with liposomal doxorubicin and intravenous zoledronic acid. After the second cycle, the patient presented with spontaneous ulcerations of 1 month of evolution with extensive areas of exposed bone on the mandibular lingual surface in areas of a mandibular torus. Osteonecrosis bisphosphonates-associated was clinically and histopathologically confirmed, and it still persists.