Botulinum toxin: a new differential diagnosis for a lytic bone lesion

Lefkovits, Y; Lipton, L

Author(s): Lefkovits, Y; Lipton, L;
Details: Publication Year 2024-03-24,Volume 18,Issue #1,Page 179
Journal Title: Journal of Medical Case Reports
Publication Type: Case report
Abstract: BACKGROUND: Botulinum toxin, produced by the Gram-positive anaerobe Clostridium botulinum, is composed of seven antigenic subtypes (A, B, C, D, E, F, and G). Currently, only Botulinum toxin type A, commonly referred to as "Botox," is approved for clinical use, given its relatively safe clinical profile. Botulinum toxin type A has a wide range of therapeutic indications, including treatment for dystonia, migraine headache, neurogenic bladder, and large muscle spastic disorders. However, the toxin is most widely known for its cosmetic effects in treating wrinkles and facial lines. CASE PRESENTATION: This article describes a 62-year-old Caucasian female who presented for investigation and workup of an isolated lytic lesion of her frontal bone a few weeks after administration of botulinum toxin injection into the corresponding site in the frontalis muscle. This presented as a large, palpable, painless forehead lump causing significant psychological distress. After no neoplastic cause for the lesion was found and histopathology was performed, our researchers concluded that the most likely explanation was that the bony lytic lesion resulted from inadvertent injection of the "Botox" neurotoxin through the intended target muscle and into the cortex of the underlying bone. CONCLUSIONS: Our search of the literature failed to identify any previous cases of this occurring. However, as the popularity of this cosmetic procedure only increases, we believe that this represents an important possible differential for isolated lytic lesion after administration of "Botox" injection.
Publisher: BioMed Central
Keywords: Female; Humans; Middle Aged; *Botulinum Toxins, Type A; *Neuromuscular Agents/therapeutic use; Diagnosis, Differential; Face; Head; Bone cancer; Case report; Clinical oncology; Imaging; Medical oncology
Department(s): Medical Oncology
Publisher's Version: https://doi.org/10.1186/s13256-024-04430-5
Open Access at Publisher's Site: https://doi.org/10.1186/s13256-024-04430-5
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-04-04 02:32:07

Last Modified: 2024-04-04 03:11:41