Work

Bilateral mandibular osteomyelitis following chemo-radiotherapy: Critical rare case report and review of literature

Year: 2025

Type: article

Abstract: INTRODUCTION AND IMPORTANCE: Osteomyelitis, an inflammatory condition of the bone, poses significant challenges in clinical management due to its multifactorial etiology and variable presentation. Understanding the underlying mechanisms, risk factors, and biological processes is essential for improving treatment outcomes. Through this paper, we present an exceptionally rare case of "bilateral" aggressive osteomyelitis affecting the mandible, resulting in significant bone loss on both sides. Additionally, we review the literature to explore the causes of this disease and the factors contributing to its occurrence, aiming to understand its pathogenesis and improve prevention and treatment methods. CASE PRESENTATION: A 58-year-old male presented to our oral and maxillofacial department with a chief complaint of intense pain on both sides of the mandible, persisting for over 12 days. According to the patient, several months ago, the pain varied from mild to moderate, but recently it has increased dramatically. His medical history revealed enlarged lymphatic nodes on both sides of the neck. Consequently, the patient underwent a surgical procedure under general anesthesia to remove the enlarged nodes, followed by chemotherapy, and then 24 sessions of radiotherapy. After a while, the patient began to experience pain of varying intensity, and ulcers appeared, which increased in size over time. DISCUSSION: After confirming the diagnosis of osteomyelitis, we identified the radiation and chemotherapy to which the patient was exposed as the primary reason for the worsening of the condition. in addition, the injury to both sides of the mandible indicates two possibilities: the first is that the patient has a predisposition to develop osteomyelitis (due to genetic factors, possible ischemia, etc.), and the second is that radiological doses he received was excessive, combined with the immunodeficiency resulting from chemotherapy, contributed to the condition. CONCLUSION: Research on jaw osteomyelitis highlights a complex interplay of factors that contribute to the development of this condition. Overall, effective prevention and management strategies should address these diverse causes.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2025.111277

Authors: Oday Bisher, Ali Khalil

Institution: Latakia University

Language: English

Topic: Oral health in cancer treatment

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090