{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:56:47Z","timestamp":1776301007512,"version":"3.50.1"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T00:00:00Z","timestamp":1613088000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T00:00:00Z","timestamp":1613088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2020R1A2C4001842"],"award-info":[{"award-number":["2020R1A2C4001842"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>This is a case of mucormycosis originated osteonecrosis of the maxilla extended to the cranial base, initially suspected of malignancy. The patient was first suspected with osteolytic sarcomatous lesion but was later diagnosed with total maxillary necrosis and cranial base through biopsy-proven invasive mucormycosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 71-year-old male was presented with unknown total maxillary osteonecrosis. CT and MRI results showed extensive osteolytic change with bone destruction of the cranial base, and PET-CT showed irregular hypermetabolic lesion in the area suspected of malignancy. The first biopsy results only presented tissue inflammation. Thus, several further endoscopic biopsy were performed through posterior pharyngeal wall. The patient was eventually diagnosed with mucormycosis and associated osteomyelitis with subsequent bone necrosis. With confirmed diagnosis, partial maxillectomy of the necrosed bone was performed under general anesthesia. At the 4\u00a0week follow-up, the patient showed full mucosal healing and no recurrence or aggravation of the maxilla and cranial base lesion was observed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Accurate diagnosis of atypical symptoms, timely diagnosis, and proper combination therapy of surgical intervention, antifungal agent, and antibiotic use for skull base osteomyelitis are all critical for proper treatment planning. In addition, biopsy and CT scans are essential in differentiating osteonecrosis from malignancy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12903-021-01411-8","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T20:35:32Z","timestamp":1613162132000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Mucormycosis originated total maxillary and cranial base osteonecrosis: a possible misdiagnosis to malignancy"],"prefix":"10.1186","volume":"21","author":[{"given":"Young Long","family":"Park","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sura","family":"Cho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1672-5730","authenticated-orcid":false,"given":"Jin-Woo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,2,12]]},"reference":[{"issue":"5","key":"1411_CR1","first-page":"828","volume":"21","author":"L-L Chan","year":"2000","unstructured":"Chan L-L, Singh S, Jones D, Diaz EM Jr, Ginsberg LE. Imaging of mucormycosis skull base osteomyelitis. Am J Neuroradiol. 2000;21(5):828\u201331.","journal-title":"Am J Neuroradiol"},{"issue":"2","key":"1411_CR2","first-page":"321","volume":"19","author":"CS Silverman","year":"1998","unstructured":"Silverman CS, Mancuso AA. Periantral soft-tissue infiltration and its relevance to the early detection of invasive fungal sinusitis: CT and MR findings. Am J Neuroradiol. 1998;19(2):321\u20135.","journal-title":"Am J Neuroradiol"},{"issue":"9","key":"1411_CR3","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1016\/j.bjoms.2014.07.256","volume":"52","author":"J-W Kim","year":"2014","unstructured":"Kim J-W, Kim S-J, Kim M-R. Leucocyte-rich and platelet-rich fibrin for the treatment of bisphosphonate-related osteonecrosis of the jaw: a prospective feasibility study. Br J Oral Maxillofac Surg. 2014;52(9):854\u20139.","journal-title":"Br J Oral Maxillofac Surg"},{"issue":"2","key":"1411_CR4","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1563\/aaid-joi-D-14-00309","volume":"42","author":"J-W Kim","year":"2016","unstructured":"Kim J-W, Kim S-J, Kim M-R. Simultaneous application of bone morphogenetic protein-2 and platelet-rich fibrin for the treatment of bisphosphonate-related osteonecrosis of jaw. J Oral Implantol. 2016;42(2):205\u20138.","journal-title":"J Oral Implantol"},{"issue":"6","key":"1411_CR5","doi-asserted-by":"publisher","first-page":"1176","DOI":"10.1016\/j.joms.2016.12.005","volume":"75","author":"J-H Park","year":"2017","unstructured":"Park J-H, Kim J-W, Kim S-J. Does the addition of bone morphogenetic protein 2 to platelet-rich fibrin improve healing after treatment for medication-related osteonecrosis of the jaw? J oral Maxillofac Surg. 2017;75(6):1176\u201384.","journal-title":"J oral Maxillofac Surg"},{"issue":"3","key":"1411_CR6","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1288\/00005537-198603000-00003","volume":"96","author":"JR Chandler","year":"1986","unstructured":"Chandler JR, Grobman L, Quencer R, Serafini A. Osteomyelitis of the base of the skull. Laryngoscope. 1986;96(3):245\u201351.","journal-title":"Laryngoscope"},{"issue":"7","key":"1411_CR7","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1288\/00005537-198907000-00001","volume":"99","author":"LR Grobman","year":"1989","unstructured":"Grobman LR, Casiano R, Goldberg S, Ganz W. Atypical osteomyelitis of the skull base. Laryngoscope. 1989;99(7):671\u20136.","journal-title":"Laryngoscope"},{"issue":"1","key":"1411_CR8","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/S0196-0709(97)90043-0","volume":"18","author":"SE Kountakis","year":"1997","unstructured":"Kountakis SE, Kemper JV Jr, Chang CYJ, DiMaio DJM, Stiernberg CM. Osteomyelitis of the base of the skull secondary to Aspergillus. Am J Otolaryngol. 1997;18(1):19\u201322.","journal-title":"Am J Otolaryngol"},{"issue":"1","key":"1411_CR9","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1148\/radiology.160.1.3715034","volume":"160","author":"JL Gamba","year":"1986","unstructured":"Gamba JL, Woodruff WW, Djang WT, Yeates AE. Craniofacial mucormycosis: assessment with CT. Radiology. 1986;160(1):207\u201312.","journal-title":"Radiology"},{"issue":"10","key":"1411_CR10","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1016\/S0161-6420(85)33844-7","volume":"92","author":"R Kohn","year":"1985","unstructured":"Kohn R, Hepler R. Management of limited rhino-orbital mucormycosis without exenteration. Ophthalmology. 1985;92(10):1440\u20134.","journal-title":"Ophthalmology"},{"issue":"5","key":"1411_CR11","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1097\/00004728-198909000-00023","volume":"13","author":"DM Yousem","year":"1989","unstructured":"Yousem DM, Galetta SL, Gusnard DA, Goldberg HI. MR findings in rhinocerebral mucormycosis. J Comput Assist Tomogr. 1989;13(5):878\u201382.","journal-title":"J Comput Assist Tomogr"},{"issue":"2","key":"1411_CR12","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1016\/j.ijrobp.2010.11.050","volume":"82","author":"KA Higgins","year":"2012","unstructured":"Higgins KA, Hoang JK, Roach MC, Chino J, Yoo DS, Turkington TG, et al. Analysis of pretreatment FDG-PET SUV parameters in head-and-neck cancer: tumor SUVmean has superior prognostic value. Int J Radiat Oncol Biol Phys. 2012;82(2):548\u201353.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"11","key":"1411_CR13","first-page":"1771","volume":"35","author":"VJ Lowe","year":"1994","unstructured":"Lowe VJ, Hoffman JM, DeLong DM, Patz EF, Coleman RE. Semiquantitative and visual analysis of FDG-PET images in pulmonary abnormalities. J Nucl Med. 1994;35(11):1771\u20136.","journal-title":"J Nucl Med"},{"issue":"2","key":"1411_CR14","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1148\/radiology.202.2.9015070","volume":"202","author":"VJ Lowe","year":"1997","unstructured":"Lowe VJ, Duhaylongsod FG, Patz EF, Delong DM, Hoffman JM, Wolfe WG, et al. Pulmonary abnormalities and PET data analysis: a retrospective study. Radiology. 1997;202(2):435\u20139.","journal-title":"Radiology"},{"issue":"3","key":"1411_CR15","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1200\/JCO.1998.16.3.1075","volume":"16","author":"VJ Lowe","year":"1998","unstructured":"Lowe VJ, Fletcher JW, Gobar L, Lawson M, Kirchner P, Valk P, et al. Prospective investigation of positron emission tomography in lung nodules. J Clin Oncol. 1998;16(3):1075\u201384.","journal-title":"J Clin Oncol"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-021-01411-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12903-021-01411-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-021-01411-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T20:43:39Z","timestamp":1613162619000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcoralhealth.biomedcentral.com\/articles\/10.1186\/s12903-021-01411-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,12]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1411"],"URL":"https:\/\/doi.org\/10.1186\/s12903-021-01411-8","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,12]]},"assertion":[{"value":"7 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"65"}}