Avascular necrosis of bone caused by combination chemotherapy without corticosteroids

Avascular necrosis of bone is sometimes a complication of cancer chemotherapy that includes corticosteroids but generally occurs at a single site. A patient with testicular teratoma who received chemotherapy that did not include steroids developed avascular necrosis of the left femoral head, left scaphoid, and both medial femoral condyles. Symptoms were relieved with anti-inflammatory drugs and physiotherapy. This case indicates that avascular necrosis may be caused by cancer chemotherapy that does not include steroids.