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Vol.63 No.2 contents | Japanese/English |
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- Case Report -
Three Cases of Bone Metastases from Lung Cancer with Bone Scintigraphy Showing the Accumulation in the Mandible Before the Appearance of Symptoms of Osteonecrosis of the Jaw
Shuji Kodama1, Masamichi Yoshida1, Hiroto Miki1, Hiroki Goto1, Kazuki Masuda1, Toshikazu Terashima1, Atsushi Fujiwara11Department of Respiratory Medicine, Mie Prefectural General Medical Center
Background. Lung cancer often metastasizes to the bone. Bone metastasis is diagnosed and evaluated by bone scintigraphy and treated with bone modifying agents. Since bone modifying agents may cause osteonecrosis of the jaw (ONJ) as a serious adverse event, their use requires caution. Case 1. A 72-year-old man with multiple bone metastases from adenocarcinoma of the lung, treated with pemetrexed and zoledronic acid. Case 2. A 62-year-old woman with postoperative recurrence of lung adenocarcinoma with multiple bone metastases, treated with osimertinib and denosumab. Case 3. A 73-year-old man with multiple bone metastases from adenocarcinoma of the lung, treated with osimertinib and denosumab. These three patients with lung cancer accompanied by multiple bone metastases developed ONJ while undergoing chemotherapy and treatment with bone-modifying agents. In all three patients, the bone scintigraphy obtained during follow-up showed the uptake of 99mTc in the mandible before the onset of ONJ symptoms. Conclusion. When bone scintigraphy is performed for early detection and treatment of ONJ during treatment with bone modifying agents, the mandible should also receive focus. Medical and dental cooperation should be promoted. If the uptake is detected, early consultation with a dentist should be performed.
key words: Osteonecrosis of the jaw, Bone scintigraphy, Bone modifying agents, Denosumab, Zoledronic acid
Received: August 4, 2022
Accepted: October 12, 2022
JJLC 63 (2): 101-106, 2023
