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A Case of Pentastomiasis at the Left Maxilla Bone in a Patient with Thyroid Cancer

  • Cho, Eunae Sandra (Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry) ;
  • Jung, Seung Wook (Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry) ;
  • Jung, Hwi-Dong (Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry) ;
  • Lee, In Yong (Department of Environmental Medical Biology, Institute of Tropical Medicine & Arthropods of Medical Importance Bank, Yonsei University College of Medicine) ;
  • Yong, Tai-Soon (Department of Environmental Medical Biology, Institute of Tropical Medicine & Arthropods of Medical Importance Bank, Yonsei University College of Medicine) ;
  • Jeong, Su Jin (Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine) ;
  • Kim, Hyun Sil (Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry)
  • Received : 2017.04.25
  • Accepted : 2017.06.17
  • Published : 2017.08.31

Abstract

Pentastomiasis, a zoonotic parasite infection, is typically found in the respiratory tract and viscera of the host, including humans. Here, we report for the first time an extremely rare case of intraosseous pentastomiasis in the human maxilla suffering from medication related osteonecrosis of the jaw (MRONJ). A 55-year-old male had continuously visited the hospital for MRONJ which had primarily developed after bisphosphonate and anti-neoplastic administration for previous bone metastasis of medullary thyroid cancer. Pain, bone exposure, and pus discharge in the right mandible and left maxilla were seen. Osteolysis with maxillary cortical bone perforation at the left buccal vestibule, palate, nasal cavity, and maxillary sinus was observed by radiologic images. A biopsy was done at the left maxilla and through pathological evaluation, a parasite with features of pentastome was revealed within the necrotic bone tissue. Further history taking and laboratory evaluation was done. The parasite was suspected to be infected through maxillary open wounds caused by MRONJ. Awareness of intraosseous pentastomiasis should be emphasized not to be missed behind the MRONJ. Proper evaluation and interpretation for past medical history may lead to correct differential diagnosis and therapeutic intervention for parasite infections.

Keywords

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