Multiple External Cervical Resorption Lesions in Patient with Graft versus Host Disease Treated with Systemic Bleomycin: A Case Report

J Endod. 2024 May;50(5):674-679. doi: 10.1016/j.joen.2024.01.019. Epub 2024 Feb 2.

Abstract

The phenomenon of multiple external cervical root resorption (ECRR) lesions in a single patient is rare but may have a link with the chemotherapeutic agent bleomycin. This case details an adult male with multiple ECRR lesions that developed following chemotherapy. His treatment regimen for Hodgkin's lymphoma included the chemotherapeutic antibiotic bleomycin, which has previously been linked with development of multiple ECRR lesions. The patient developed graft versus host disease following an allogeneic stem cell transplant, which could have a significant role in the development and promotion of the ECRR lesions. In total, 8 teeth developed ECRR, and all the known causative factors were excluded when examined. To our knowledge, this is only the second reported case in the literature to link bleomycin to multiple ECRR lesions. This case report aims to bring the reader's attention to the fact that multiple cervical resorption lesions can develop simultaneously. These lesions can be difficult to diagnose and treat and are often misdiagnosed as caries. Finally, the reader should consider the possible role of bleomycin and graft versus host disease in development of multiple lesions of ECRR.

Keywords: Chemotherapy; external cervical resorption; graft versus host disease; root resorption.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibiotics, Antineoplastic* / adverse effects
  • Antibiotics, Antineoplastic* / therapeutic use
  • Bleomycin* / therapeutic use
  • Graft vs Host Disease* / complications
  • Graft vs Host Disease* / drug therapy
  • Hodgkin Disease* / complications
  • Hodgkin Disease* / drug therapy
  • Humans
  • Male
  • Root Resorption* / diagnostic imaging

Substances

  • Bleomycin
  • Antibiotics, Antineoplastic