NUMERO: #20250313

Título: ATYPICAL MEDICATION-RELATED OSTEONECROSIS DURING MULTIPLE MYELOMA TREATMENT: A CASE REPORT.

Nome do Apresentador: Otávio Augusto de MELO

Categoria do Trabalho: Painel de caso clínico (PCC)

Área Temática: Odontologia hospitalar

Resumo: We report an atypical case of medication-related osteonecrosis of the jaw (MRONJ) affecting torus palatinus in a 74-year-old male patient with multiple myeloma treated with Lenalidomide and antireasorptive therapy (Zometa followed by Denosumab, monthly). The patient presented with persistent palatal pain for one month. Intraoral examination revealed an indurated nodular lesion along the midline of hard palate, with exposed bone and granulomatous pustules. Differential diagnoses included MRONJ and plasmacytoma. An incisional biopsy confirmed osteonecrosis. Conservative treatment was initiated, including systemic antibiotics, weekly photobiomodulation, antimicrobial photodynamic therapy, chlorhexidine irrigation, and debridement of granulation tissue and bone sequestra. Although clinical improvement was observed, recurrent infections led to the indication of surgical resection. Intraoperative aPDT and postoperative photobiomodulation were performed. The patient recovered well, with complete resolution of symptoms. This case highlights an unusual MRONJ presentation and the importance of multidisciplinary management.

Autor 1:  Otávio Augusto de MELO

E-mail 1:  [email protected]

Autor 2:   Mariana Henriques FERREIRA

E-mail 2:  [email protected]

Autor 3 :  Fernanda de Paula EDUARDO

E-mail 3:  [email protected]

Autor 4:  Juliana Mota SIQUEIRA

E-mail 4:  [email protected]

Autor 5:  Anna Luíza Damaceno ARAÚJO

E-mail 5:  [email protected]

Autor 6:  Karen Müller RAMALHO

E-mail 6:  [email protected]

Autor 7:  Leticia Mello BEZINELLI

E-mail 7:  [email protected]