Lincoln Sign: A Rare Presentation of Medication-related Osteonecrosis of the Jaw
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P: 118-120
June 2024

Lincoln Sign: A Rare Presentation of Medication-related Osteonecrosis of the Jaw

Mol Imaging Radionucl Ther 2024;33(2):118-120
1. Tuen Mun Hospital Department of Radiology and Nuclear Medicine, Nuclear Medicine Unit, Hong Kong, China
No information available.
No information available
Received Date: 17.10.2023
Accepted Date: 17.12.2023
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ABSTRACT

A 52-year-old female patient with metastatic breast cancer receiving denosumab for 7 years presented with marked diffuse tracer uptake in the mandible on Tc-99m-methylene diphosphonate bone scintigraphy, resembling the Lincoln sign. A diagnosis of medication-related osteonecrosis of the jaw (MRONJ) was confirmed, leading to immediate discontinuation of denosumab. Conservative therapy, including limited debridement and oral rinses, was initiated. MRONJ, a potential complication of bone-modifying agents, is more prevalent in advanced malignancy cases. The Lincoln sign has not been previously reported in MRONJ, emphasizing its consideration in cancer patients undergoing bone-modifying agent treatment.

References

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