Maxilla Osteonecrosis: a differential diagnosis in patients with metastatic cancer on bisphosphonates

Bisphosphonate-induced osteonecrosis of the mandible and/or maxilla is an increasingly recognized, though still rare complication of bisphosphonate therapy. In the present case, the patient presented with a seven-month history of maxillary sinusitis and pain, and was originally diagnosed with a bony metastasis from her primary breast cancer. However, surgical excision and biopsy led to a diagnosis of bisphosphonate-induced osteonecrosis of the maxilla. As bisphosphonates are often prescribed for patients with metastatic disease, it is important to recognize that bisphosphonate-induced osteonecrosis may present similarly to bony metastases.