OSTEONECROSIS OF THE JAW (ONJ) IN DIFFERENTIATED THYROID CANCER (DTC): A CASE REPORT AFTER ZOLEDRONIC ACID AND LENVATINIB TREATMENT

Patients with Differentiated Thyroid Cancer (DTC) and bone metastases (BM) have generally poor prognosis and low survival rate. The management is based on radioiodine therapy, local procedures and systemic therapies, such as kinase inhibitors. The use of antiresorptive drugs (bisphosphonates or denosumab) is essential to prevent skeletal-related events (SREs), and improve quality of life. The concomitant association of antiangiogenic therapies and antiresorptive treatments have been associated with occurrence of Osteonecrosis of the Jaw (ONJ). We report a case of ONJ in a 74 years old man treated with concomitant lenvatinib and zoledronic acid for advanced iodine-refractory DTC and BM, developing ONJ almost 8 years after start of zoledronic acid and 34 months after beginning of lenvatinib.