日本口腔外科学会雑誌
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
症例報告
下顎歯肉扁平上皮癌と頸部原発悪性リンパ腫の同時性重複がんの1例
首藤 敦史竹信 俊彦平井 雄三山本 信祐谷池 直樹宇佐美 悠
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2017 年 63 巻 1 号 p. 45-50

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We report a case of synchronous squamous cell carcinoma of the mandibular gingiva and primary malignant lymphoma of the neck. A 51-year-old man was referred to our hospital for further evaluation of an intractable gingival ulcer. Physical examination at initial presentation showed an ulcerative lesion of the left mandibular molar gingiva with an irregular border and induration, which was diagnosed as squamous cell carcinoma on abiopsy. An imaging study showed mandibular invasion of squamous cell carcinoma and metastases to the left cervical lymph nodes. Marginal resection of the mandible and left neck dissection were performed with the patient under general anesthesia. There was no histopathological evidence of cervical lymph node metastasis. However, postoperative physical and radiographic findings at 2 months showed two swollen lymph nodes in the right side of the neck, suggesting early metastases to the contralateral cervical lymph nodes. Right neck dissection was performed with the patient under general anesthesia, and the histopathological diagnosis was malignant lymphoma (marginal zone B-cell lymphoma). The final diagnosis was synchronous squamous cell carcinoma of the mandibular gingiva and primary malignant lymphoma of the neck. The patient was strictly followed up with no additional treatment because of the low malignancy of marginal zone B-cell lymphoma. There has been no evidence of recurrence or metastasis during the 6 years 9 months after the operation.

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