title: [A Case of Bisphosphonate-Related Osteonecrosis of the Jaw with Difficulty in Treatment].
abstract: A 65-year-old man with urination difficulty visited our hospital. Because his prostate-specific antigen level was 1,619 ng/ml, we performed a prostate biopsy. The biopsy specimen yielded a diagnosis of adenocarcinoma with a Gleason score of 4＋4. Computed tomography and bone scintigraphy showed lymph node, lung, and bone metastasis (cT3bN1M1). After 13 months of combined androgen blockade, he underwent treatment with a bisphosphonate. At 22 months of treatment, he developed bisphosphonate-related osteonecrosis of the jaw, and all necrotic bone and teeth were removed. He subsequently underwent repeated cleaning and fixation (splinting) for an oral fistula and mandibular fracture. Emergency transcatheter arterial embolization was then performed to treat a bleeding of the facial artery aneurysm. An oral infection and aspiration pneumonia repeatedly developed secondary to the oral fistula. The patient underwent a gastrostomy, after which his nutritional status improved and he was discharged.
authors.affiliation: The Department of Urology, Kurashiki Central Hospital.
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: The Department of Urology, Kurashiki Central Hospital.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fukumoto
authors.affiliation: The Department of Urology, Kurashiki Central Hospital.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Fukui
authors.affiliation: The Department of Urology, Kurashiki Central Hospital.
authors.forename: Toru
authors.initials: T
authors.lastname: Sakatani
authors.affiliation: The Department of Urology, Kurashiki Central Hospital.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Atsuta
authors.affiliation: The Department of Urology, Kurashiki Central Hospital.
authors.forename: Takuma
authors.initials: T
authors.lastname: Kato
authors.affiliation: The Department of Urology, Kurashiki Central Hospital.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.affiliation: The Department of Urology, Kurashiki Central Hospital.
authors.forename: Koji
authors.initials: K
authors.lastname: Inoue
authors.affiliation: The Department of Urology, Kurashiki Central Hospital.
authors.forename: Akito
authors.initials: A
authors.lastname: Terai
mesh_terms: D000368:Aged; D001706:Biopsy; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis*; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates