Osteolytic lesion of the mandible in a 42‐year‐old female

Abstract

A case of metastatic breast cancer with medication‐related osteonecrosis of the jaws is described in a
42‐year‐old Hispanic female who was previously unaware of a preexisting breast carcinoma. Radiographic
examination demonstrated the absence of visible lamina dura and periodontal ligament on teeth in the
affected area; while clinical examination demonstrated a moderately diffuse swelling of the right mandible
and vestibule without distinct masses. Microscopy revealed disordered lesional cells with moderate variations
in nuclear size, shape, and chromaticity, with a low mitotic index. Also noted were segments of necrotic
remodeled resorbed lamellar bone showing enlarged empty osteocytic lacunae, a serrated external surface,
adherent granular basophilic bacteria, and a fibrinous exudate with neutrophils.