alexa Atypical Femoral Fracture in a Patient with Metastatic Breast Cancer During Denosumab Therapy
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Atypical Femoral Fracture in a Patient with Metastatic Breast Cancer During Denosumab Therapy

Kazuhiro Ohnaru1, Toyohiro Kawamoto2, Yutaka Yamamoto3, Kensuke Tanaka4, Sigeru Mitani2, Toru Hasegawa1, Masayuki Inubushi4 and Teruki Sone4*
1Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
2Department of Bone and Joint Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
3Department of Breast and Thyroid Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
4Department of Nuclear Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan
*Corresponding Author : Teruki Sone
Department of Nuclear Medicine, Kawasaki Medical School 577 Matsushima
Kurashiki, Okayama 701-0192, Japan
Tel: +81-86-462-1111
Fax: +81-86-462-1199
E-mail: [email protected]
Rec date: Jan 20, 2016; Acc date: Mar 05, 2016; Pub date: Mar 08, 2016
Citation: Ohnaru K, Kawamoto T, Yamamoto Y, Tanaka K, Mitani S, et al. (2016) Atypical Femoral Fracture in a Patient with Metastatic Breast Cancer During Denosumab Therapy. J Clin Case Rep 6:737. doi:10.4172/2165-7920.1000737
Copyright: © 2016 Ohnaru K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

A case of a 62-year-old woman with breast cancer who developed an atypical femoral fracture during denosumab therapy for bone metastasis is reported. About 8.5 years before the fracture, she was diagnosed with breast cancer with liver and bone metastases and started receiving chemotherapy. Three and a half years later, zoledronic acid (40 mg every 4 weeks) was added, which was continued for 2 years and 4 months. At around 1.5 years after discontinuation of zoledronic acid, bone metastasis recurred and she began treatment with denosumab at 120 mg every 4 weeks. Fifteen months after starting denosumab, she sustained a left subtrochanteric fracture. Faint hot spots in the bilateral subtrochanteric regions were found on bone scintigraphy 2 months after the start of denosumab, and the tracer accumulation was slightly increased on bone scintigraphy 1 year later. Prior to the fracture, she had been experiencing a dull ache in her left thigh for a few months. Our case suggests that denosumab treatment for bone metastasis is a risk factor for atypical femoral fractures, and that thigh pain and subtrochanteric hot spots on bone scintigraphy could be signs of an impending fracture.

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