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Case Report ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Endocrinol. | doi: 10.3389/fendo.2019.00803

Co-administration of systemic and intralesional zoledronic acid in a case of fibrous dysplasia: A potentially novel therapy

  • 1Post Graduate Institute of Medical Education and Research (PGIMER), India
  • 2Department of Orthopaedics, Post Graduate Institute of Medical Education and Research (PGIMER), India

Fibrous dysplasia (FD) is a benign bone lesion characterized by replacement of normal bone with abnormal fibrous tissue, clinically manifesting as deformities, bone pains and pathological fractures. The standard medical management for FD includes systemic bisphosphonate therapy. The efficacy of systemic bisphosphonate is however limited with minimal functional improvement and pain relief. Keeping the above lacunae in mind, we have made a solitary attempt at treating FD with locally administered zoledronic acid. A 25-year-old gentleman had presented to our institute with swelling and pain involving the left thigh and left lower leg. He was diagnosed as having polyostotic FD, confirmed on bone histopathology. He was administered 4 mg of zoledronic acid intravenously while 1 mg of the drug was injected locally into the femoral lesion under ultrasound and fluoroscopy guidance. There were no peri-procedural complications. At 6 months follow-up, there was marked improvement in pain scores at the left thigh, while that at the left leg remained unchanged. In addition, repeat bone scintigraphy showed a 20.8% and 25.3% reduction in anterior and posterior uptake values, respectively, at the left femur while that at the left tibia remained unchanged.

Keywords: Fibrous dysplasia (FD), Bisphosphonate, Zoledronate, Local bisphosphonate, implant fixation

Received: 09 Jul 2019; Accepted: 04 Nov 2019.

Copyright: © 2019 Bhadada, Pal, Sood, Dhiman and Saini. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Sanjay K. Bhadada, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160 012, Punjab, India, bhadadask@rediffmail.com