J Korean Assoc Oral Maxillofac Surg 2017; 43(2): 120~124
A rare case of osteonecrosis of the jaw related to imatinib
Massimo Viviano1, Marco Rossi2, Serena Cocca3
1Department of Medical Biotechnologies (Dentistry),
2Department of Medicine, Surgery and Neuroscience (Pharmacology),
3Department of Medicine, Surgery and Neuroscience (ENT), University of Siena, Siena, Italy
Serena Cocca
Department of Medicine, Surgery and Neuroscience (ENT), University of Siena, Viale Bracci, 14, Siena 53100, Italy
TEL: +39-3201525334
FAX: +39-0577585771
E-mail: mailarticoli@libero.it
Received May 23, 2016; Revised July 28, 2016; Accepted August 13, 2016.; Published online April 30, 2017.
© Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Osteonecrosis of the jaw (ONJ) is commonly described as an adverse effect of the use of bisphosphonates. A few cases of ONJ associated with tyrosine kinase inhibitors (sunitinib, imatinib) have been reported in the literature and usually they occurred in patients simultaneously treated with bisphosphonates. We report an atypical case of ONJ related only to imatinib. A 72-year-old male patient was treated with imatinib for metastases from gastrointestinal stromal tumors (GISTs). The patient developed ONJ after 22 months of imatinib only therapy. During his whole life, the patient had never been treated with bisphosphonates or radiotherapy. Microscope examination of the tissues confirmed the clinical diagnosis of diffuse osteonecrosis and showed absence of neoplastic cells. Thus, secondary localisations from GISTs were ruled out. Osteonecrosis of the lower jaw appeared 22 months after initial and exclusive therapy with imatinib. Therefore, imatinib monotherapy can induce ONJ in patients that have never been treated with bisphosphonates or radiotherapy.
Keywords: Imatinib mesylate, Osteonecrosis, Oral surgery, Gastrointestinal stromal tumors, Bone remodeling

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31 October 2017
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