A 64-year-old woman with a personal history of breast carcinoma and multiple bone metastases to the skull, sternum, and sacrum was treated with an aromatase inhibitor. Due to her bone pain, we started intravenous zoledronic acid therapy in December 2004: 4 mg was administered every 28 days. The pain was successfully controlled a few months later, and she ceased taking analgesics.

During this treatment period she didn’t have any complications related to the bone metastases. However, after 16 drug infusions, she consulted us in October 2006 because of pain at the left lower jawbone.

The CT scan (Figure 1) showed an osteolytic lesion with central and peripheral areas of bone sclerosis. The gammagraphic study (Figure 2) revealed an intense hypercaptation at the left jaw in addition to that known at the skull and spinal column.

Author information: Iñaki Alvarez-Busto, Oncologist1; Luis Martínez-Moya, Internist2; Rodrigo Lastra Oncologist1; Javier Alcedo, Physician1; Dámaris Quiles, Registered Nurse1; Antonio Lobo-Escolar, Physician2; Carlos Vázquez, Physician1; Miguel Burillo Oncologist, Chief of Department1; Carla Toyas-Miazza, Internist2; Rosario Ortas-Nadal, Internist2

Correspondence: Dr Iñaki Alvarez-Busto, Department of Medical Oncology, University Hospital “San Jorge”, Martínez Velasco Avenue 24, 22004, Huesca, Spain. Email: INAKI.ALVAREZ@terra.es