A case of sternal osteomyelitis during treatment with everolimus for recurrent breast cancer

Abstract Background Everolimus is a mechanistic-target-of-rapamycin (mTOR) inhibitor bearing a potent antitumor effect against hormone receptor-positive breast cancer. Here, we report the case of a patient with recurrent breast cancer who developed osteomyelitis during the treatment with everolimus...

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Main Authors: Kaori Abe, Masafumi Shimoda, Tetsuhiro Yoshinami, Yoshiaki Sota, Tomohiro Miyake, Tomonori Tanei, Naofumi Kagara, Yasuto Naoi, Kenzo Shimazu
Format: Article
Language:English
Published: Japan Surgical Society 2022-01-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-022-01376-y
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author Kaori Abe
Masafumi Shimoda
Tetsuhiro Yoshinami
Yoshiaki Sota
Tomohiro Miyake
Tomonori Tanei
Naofumi Kagara
Yasuto Naoi
Kenzo Shimazu
author_facet Kaori Abe
Masafumi Shimoda
Tetsuhiro Yoshinami
Yoshiaki Sota
Tomohiro Miyake
Tomonori Tanei
Naofumi Kagara
Yasuto Naoi
Kenzo Shimazu
author_sort Kaori Abe
collection DOAJ
description Abstract Background Everolimus is a mechanistic-target-of-rapamycin (mTOR) inhibitor bearing a potent antitumor effect against hormone receptor-positive breast cancer. Here, we report the case of a patient with recurrent breast cancer who developed osteomyelitis during the treatment with everolimus plus exemestane. Case presentation A 56-year-old woman with early-stage breast cancer underwent right mastectomy and axillary lymph node dissection at the age of 45. Four years after the surgery, she experienced relapse at the chest wall. Radiotherapy was performed on the chest wall, including the sternum, and denosumab was administered. After several regimens of hormonal therapies, everolimus in combination with exemestane was administered. Three months later, the patient visited our clinic because of continuous fever. A computed tomography scan showed an osteolytic change in the sternal bone with pneumomediastinum, which indicated sternal osteomyelitis. Extensive debridement followed by secondary reconstruction of the chest wall was successfully performed. Conclusions Everolimus may cause osteomyelitis of the affected bone as a result of tumor necrosis. Everolimus-induced osteomyelitis may be manageable by extensive debridement performed without delay.
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spelling doaj-art-eba388cc49fd4a3d90db9f002a36da612025-08-20T02:51:46ZengJapan Surgical SocietySurgical Case Reports2198-77932022-01-01811410.1186/s40792-022-01376-yA case of sternal osteomyelitis during treatment with everolimus for recurrent breast cancerKaori Abe0Masafumi Shimoda1Tetsuhiro Yoshinami2Yoshiaki Sota3Tomohiro Miyake4Tomonori Tanei5Naofumi Kagara6Yasuto Naoi7Kenzo Shimazu8Department of Breast and Endocrine Surgery, Osaka University Graduate School of MedicineDepartment of Breast and Endocrine Surgery, Osaka University Graduate School of MedicineDepartment of Breast and Endocrine Surgery, Osaka University Graduate School of MedicineDepartment of Breast and Endocrine Surgery, Osaka University Graduate School of MedicineDepartment of Breast and Endocrine Surgery, Osaka University Graduate School of MedicineDepartment of Breast and Endocrine Surgery, Osaka University Graduate School of MedicineDepartment of Breast and Endocrine Surgery, Osaka University Graduate School of MedicineDepartment of Breast and Endocrine Surgery, Osaka University Graduate School of MedicineDepartment of Breast and Endocrine Surgery, Osaka University Graduate School of MedicineAbstract Background Everolimus is a mechanistic-target-of-rapamycin (mTOR) inhibitor bearing a potent antitumor effect against hormone receptor-positive breast cancer. Here, we report the case of a patient with recurrent breast cancer who developed osteomyelitis during the treatment with everolimus plus exemestane. Case presentation A 56-year-old woman with early-stage breast cancer underwent right mastectomy and axillary lymph node dissection at the age of 45. Four years after the surgery, she experienced relapse at the chest wall. Radiotherapy was performed on the chest wall, including the sternum, and denosumab was administered. After several regimens of hormonal therapies, everolimus in combination with exemestane was administered. Three months later, the patient visited our clinic because of continuous fever. A computed tomography scan showed an osteolytic change in the sternal bone with pneumomediastinum, which indicated sternal osteomyelitis. Extensive debridement followed by secondary reconstruction of the chest wall was successfully performed. Conclusions Everolimus may cause osteomyelitis of the affected bone as a result of tumor necrosis. Everolimus-induced osteomyelitis may be manageable by extensive debridement performed without delay.https://doi.org/10.1186/s40792-022-01376-ySternal osteomyelitisEverolimusmTOR inhibitorBreast cancerDenosumab
spellingShingle Kaori Abe
Masafumi Shimoda
Tetsuhiro Yoshinami
Yoshiaki Sota
Tomohiro Miyake
Tomonori Tanei
Naofumi Kagara
Yasuto Naoi
Kenzo Shimazu
A case of sternal osteomyelitis during treatment with everolimus for recurrent breast cancer
Surgical Case Reports
Sternal osteomyelitis
Everolimus
mTOR inhibitor
Breast cancer
Denosumab
title A case of sternal osteomyelitis during treatment with everolimus for recurrent breast cancer
title_full A case of sternal osteomyelitis during treatment with everolimus for recurrent breast cancer
title_fullStr A case of sternal osteomyelitis during treatment with everolimus for recurrent breast cancer
title_full_unstemmed A case of sternal osteomyelitis during treatment with everolimus for recurrent breast cancer
title_short A case of sternal osteomyelitis during treatment with everolimus for recurrent breast cancer
title_sort case of sternal osteomyelitis during treatment with everolimus for recurrent breast cancer
topic Sternal osteomyelitis
Everolimus
mTOR inhibitor
Breast cancer
Denosumab
url https://doi.org/10.1186/s40792-022-01376-y
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