Osteonecrosis of jaw after antiangiogenic agent administration in a renal cell carcinoma patient

A 62-year-old patient had characteristics corresponding to the diagnostic criteria of medication-related osteonecrosis of the jaw (MRONJ). She had been treated for renal cell carcinoma with radical nephrectomy and chemotherapy with pazopanib (Votrient®) and everolimus (Afinitor®) antiangiogenic agents. There was no history of radiation therapy, obvious metastatic disease or surgical treatment. Bone exposure was observed in both mandibular posterior regions. Bone necrosis had developed surrounding the #35=37 and 46, 47 implants installed 6 years prior. The lesions were diagnosed as MRONJ and the patient was treated by sequestrectomy, saucerization and reconstruction with a reconstruction plate. The clinical results were good.