Oral medicine case book 61 : oral malignant melanoma : case book

A 45-year old male patient presented at the Oral and Maxillofacial Clinic, Tygerberg, with a pathological fracture of the left mandible following an extraction. The medical records of the patient revealed a history of multiple myeloma that was treated with Aredia (pamidronate disodium, an intravenous form of bisphosphonate), cyclophosphamide (an alkylating agent) and dexamethaxone (an anti-inflammatory and immunosuppressant drug). An orthopantomograph revealed osteonecrosis and pathological fracture of the left mandible, thought to be due to the earlier biphosphonate administration. The patient received conservative management for the osteonecrosis and was stable at the time of the publication, (19 months after the initial presentation with the pathological fracture).