Philippine E-Journals

Actinomycosis in Bisphosphonate-related Osteonecrosis of the Jaw in a Patient with Advanced Stage Breast Cancer

Maria Pia T. Advincula-Salvador | Michael D. San-Juan | Candice Que-ansorge | Edna M. Edrada | Rontgene M. Solante

 

Abstract:

The occurrence of uncommon infectious complications associated with malignant tumors has been observed, and may be due to the depressed immunologic surveillance. This is a case of 67-year-old female, diagnosed with bisphosphonate-related osteonecrosis of the jaw, orocervicofacial actinomycosis, and breast cancer stage 4 with bone metastases. The patient presented with gingival swelling with exposed right alveolar bone, covered with yellowish granular debris, after undergoing tooth extraction. Mandibular radiograph revealed unremarkable findings. Ct scan of the mandible revealed mixed lytic and hypersclerotic changes at the symphysis and right body of the mandible with cortical discontinuities and fragmentation. There was surrounding soft tissue thickening as well as sclerosis of the right mandibular ramus. She was discharged after completing 6 weeks of treatment with penicillin and took amoxicillin for 12 months. She eventually underwent elective segmental mandibulectomy in another hospital.