Zoledronate-related osteonecrosis of the mandible.

We report the PET-CT appearance of Zoledronate-related osteonecrosis of the mandible in a 54-year-old woman with right breast cancer with osseous and pulmonary metastases. Her treatment included surgery, chemotherapy and Zoledronate, and external beam radiation treatment. During the course of treatment, the patient developed osteonecrosis of the jaw secondary to Zoledronate, which was biopsy-proven, for which Zoledronate was discontinued shortly after. Hybrid PET-CT was performed approximately 1 year after the discontinuation of Zoledronate. PET-CT images demonstrated diffuse, intense hypermetabolism in the mandible, consistent with documented osteonecrosis.