Type:
Educational Exhibit
Keywords:
Head and neck, Oncology, CT, PET, Radiation effects, Radiation therapy / Oncology, Cancer
DOI:
10.26044/ranzcr2022/R-0125
Background
Osteoradionecrosis is a rare but significant late complication observed in pateints treated with radiation for head and neck cancers.1 It is characterised by loss of bone viability and healing defect that is induced by radiation.2 The mandible is more commonly affected than the maxilla as it is ofen involved in radiation fields.2
MJ, a 67 year old female presented with two weeks history of increasing left jaw pain. The pain was exacerbated by motion, and she reported limited mouth opening which limited her oral intake. She had a background of left buccal squamous cell carcinoma in 2018 which was managed with a wide local excision and right fibular free flap. She also received adjuvant radiotherapy of Gy in 30 fractions via VMAT partial arcs. She denied a history of smoking and had minimal alcohol intake.
On examination, there was an ulceration of her left buccal mucosa and a palpable sequestrum in the left mandibular alveolus. There was no pus discharge or oral cutaneous fistula.