日本口腔外科学会雑誌
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
53 巻, 5 号
選択された号の論文の13件中1~13を表示しています
  • 虎谷 茂昭, 谷 亮治, 福井 康人, 福原 泰明, 小泉 浩一, 佐渡 友浩, 林 大祐, 神田 拓, 吉岡 幸男, 岡本 哲治
    2007 年 53 巻 5 号 p. 262-270
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    It has been reported that photodynamic therapy (PDT) is a very effective treatment for superficial oral malignancies, without affecting the adjacent normal tissue. In this paper, we describe the successful use of PDT for the treatment of early stage gingival carcinomas and report clinical outcomes.
    The effect of PDT with a combination of Photofrin and Excimer dye lasers was evaluated for 16 lesions in 14 patients with superficial gingival squamous cell carcinomas. Each patient received Photofrin (2mg/kg) 48-60 hours befor photoradiation with 100-200 J/cm2 red laser light (630nm) delivered by an Excimer dye laser. The therapeutic efficacy was evaluated 4 weeks after PDT. Fifteen of the 16 lesions showed a complete response (93.8%), and the other lesion showed a partial response. Histological evaluation according to Ohoshi and Shimozato's classification revealed that 12 lesions were class IV b, and 4 were class II b. After at least 1 year of follow-up, 1 of 9 lesions showing a complete response had recurrence. There were no serious complications, except for skin photosensitivity reactions and sequestration of the alveolar ridge.
    We conclude that PDT using Photofrin as a photosensitizer is an effective primary treatment for superficial gingival carcinomas, with excellent healing and minimal side effects.
  • 片桐 渉, 網野 かよ子, 中澤 光博, 有本 絵美子, 中野 旬之, 由良 義明
    2007 年 53 巻 5 号 p. 271-274
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    Dermoid or epidermoid cysts usually appear as a midline swelling in the sublingual region or the floor of the mouth. There have been several case reports of lateral neck epidermoid cysts, which are considered to arise as median cysts and extend to the space between the mylohyoid and hyoglossus muscles. We report a rare case of epidermoid cyst arising between the submandibular gland and the platysma. A 40-year-old woman was referred to our hospital for evaluation of an asymptomatic swelling in the submandibular region. The MR imaging showed a well-defined cystic mass between the submandibular gland and the platysma. The lesion was extirpated under general anesthesia. No adhesion to the surrounding tissues was observed. White caseous material was contained in the lesion. Histopathologically, the cyst lumen was filled with keratin and lined by stratified squamous epithelium. There was no skin appendage, and a final diagnosis of epidermoid cyst was made. The postoperative course has been good, without any complications.
  • 岩城 太, 大西 正信, 橋本 公夫
    2007 年 53 巻 5 号 p. 275-279
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    A squamous odontogenic tumor is defined as a benign odontogenic neoplasm according to the WHO classification. Histopathological findings include islands of well-differentiated squamous epithelium in a fibrous stroma. We report the case of a squamous odontogenic tumor with resorption of the maxilla.
    A 50-year-old man presented with painless swelling of the right upper gingiva. Oral examination showed extensive swelling of the right anterior maxilla with ulceration of the gingiva. CT and MR findings revealed a mass extending to the nasal cavity and maxillary sinus. Histopathological examination of a biopsy specimen suggested that the lesion was an intraosseous carcinoma. En bloc resection of the right maxilla was performed. The histopathological diagnosis of the surgical specimen was a squamous odontogenic tumor. Postoperative healing was uneventful.
  • 筑丸 寛, 松井 義郎, 平下 光輝, 青木 紀昭, 小澤 知倫, 藤内 祝
    2007 年 53 巻 5 号 p. 280-284
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    Hyper-IgE recurrent infection syndrome is a very rare primary immunodeficiency characterized by recurrent staphylococcal infections of the skin and lungs and extremely high levels of IgE in serum. This paper describes our experience with tooth extraction in a patient with hyper-IgE recurrent infection syndrome.
    Because of pain in the right lower third molar region, a 23-year-old man with hyper-IgE recurrent infection syndrome was referred to our department on June 18, 2004. An periapical lesion of the right lower third molar was detected on X-ray examination. The clinical diagnosis was apical periodontitis. On extraction of the tooth, we performed prophylactic treatment based on the pathogens detected on past infections of the patient, the results of bacterial culture this time, and reports on infections of the oral cavity. The postoperative course was uneventful.
  • 臼井 弘幸, 佐藤 徹, 山本 英雄, 浅田 洗一, 中山 礼子, 石橋 克禮
    2007 年 53 巻 5 号 p. 285-288
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    Keratocystic odontogenic tumor commonly occurs in the posterior body and ramus of the mandible. Rarely, however, it develops in the attached gingiva or alveolar mucosa and exhibits the same histopathologic features. The lesion clinically resembles a gingival cyst in adults. Differential diagnosis is therefore difficult. We encountered a case of keratocystic odontogenic tumor arising in the mandibular gingiva and report it as a peripheral keratocystic odontogenic tumor.
    A 53-year-old man was referred to our department because of an asymptomatic swelling measuring 6 mm in diameter at the gingiva attached to the labia near teeth 2 3. The swelling was covered with normally appearing mucosa and had a whitish hue. The lesion was fluctuant on palpation and had neither spontaneous pain nor tenderness. The teeth adjacent to the lesion were noncarious, and confirmed pulp vitality by electrical stimulation. The lesion was totally excised with a 1-mm margin of normal gingiva under local anesthesia. The alveolar bone adjacent to the lesion had undergone pressure resorption. Exposure of the root surface of 2 3 was noted intraoperatively. Histopathologically, a cystic space was located within the gingival soft tissue. It was lined by parakeratotic stratified squamous epithelium composed of several cell layers and lacking rete pegs. No recurrence was noted for 6 years.
  • 大津 奈央, 高岡 一樹, 名取 淳, 野口 一馬, 櫻井 一成, 浦出 雅裕
    2007 年 53 巻 5 号 p. 289-292
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    We report a case of neurothekeoma occurring in the gingiva of the anterior part of the mandible. A 48-year-old man visited our clinic on November 13, 2002 because of a gradually enlarging mass in the gingiva of the anterior part of the mandible. Oral examination revealed a pedunculated mass measuring 13×30×15mm. The histological diagnosis of a biopsy specimen was epulis fibrosa. After admission to our hospital, mass excision with extraction from the right canine to the left premolar was performed under general anesthesia on January 21, 2003. The surgical specimen was histologically diagnosed as neurothekeoma. On immunohistochemical examination, the tumor cells were positive for vimentin, NSE, and S-100 protein. There was no local recurrence after surgery.
  • 小林 大輔, 岩渕 絵美, 岩渕 博史, 内山 公男, 田中 陽一
    2007 年 53 巻 5 号 p. 293-296
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    Metastatic tumors of the oral region are rare, comprising approximately 1 % of all malignant oral neoplasms. Their prognosis is generally poor. We report a case of metastatic renal cell carcinoma that initially presented as a tumor of the lower gingiva. The patient was a 68-year-old man who visited our department because of a swelling of the lower gingiva. Biopsy was performed, and gingival metastasis from renal cell carcinoma was strongly suspected on histopathological examination. Further examinations were performed. Renal cell carcinoma with metastases to the lung, cervical vertebrae, and ribs was diagnosed. Although the gingival metastatic tumor was relatively localized, marginal resection of the mandible was done under general anesthesia. The patient then underwent nephrectomy, radiotherapy, and interferon therapy at the department of urology. There has been no recurrence at the primary lesion or oral cavity, and the other metastatic lesions are well controlled.
  • 野口 忠秀, 土屋 欣之, 松村 俊男, 伊藤 弘人, 神部 芳則, 草間 幹夫
    2007 年 53 巻 5 号 p. 297-300
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    A case of gingival squamous cell carcinoma producing G-CSF is reported.A 78-year-old man presented with a granulated mass in the right upper gingiva. Pathological examination of a biopsy specimen revealed a welldifferentiated squamous cell carcinoma. Laboratory ndings on admission showed marked leukocytosis (12.3×103/μl).
    We had planned a partial resection of the maxilla under general anesthesia. However, the operation was canceled on the originally scheduled day, because of fever and leukocytosis (13.6×103/μl).
    After 10 days, tumor resection was performed under general anesthesia, despite fever and leukocytosis (18.3×103/μl). Postoperatively, the patient's white blood cell count soon decreased, and the fever disappeared.
    Immunohistochemically staining with monoclonal anti-G-CSF antibody was positive. The serum G-CSF concentration reached an abnormally high level preoperatively, which soon decreased to the normal range postoperatively.
    We diagnosed the disease as gingival squamous cell carcinoma producing G-CSF.
  • 高須 曜, 小泉 文, 堀本 進
    2007 年 53 巻 5 号 p. 301-303
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    We report a case of binary occurrence of osseous choristoma of the tongue in a 25-year-old woman. To date, 82 cases of osseous choristoma of the oral region have been reported. However, the binary occurrence of tumors has not been described previously.
  • 山近 重生, 中川 洋一, 長島 弘征, 保志場 大吾, 斎藤 一郎, 石橋 克禮
    2007 年 53 巻 5 号 p. 304-308
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    Aplasia of the major salivary glands is a extremely rare congenital disease and may be partial or total, unilateral or bilateral, and solitary or associated with other developmental abnormalities. We reported two cases of aplasia of the major salivary glands with xerostomia, diagnosed on MR imaging.
    The first patient was a 33-year-old man with xerostomia and thirst. There was no secretion of saliva from the orifice of the parotid gland, and both resting and stimulated saliva flow rate were decreased. Bilateral absence of the parotid glands was confirmed by MR imaging; the glands were replaced by fat. In addition, a 99mTc scintiscan confirmed the absence of uptake into the parotid gland.
    The second patient was a 40-year-old woman with xerostomia and multiple dental caries. She was aware of a sensation of oral dryness for 30 years. No saliva was delivered from the orifice of either the submandibular or parotid glands, and the saliva flow was decreased. Bilateral absence of the parotid and submandibular glands was observed on MR imaging.
  • 山崎 裕, 加藤 卓己, 佐藤 健彦, 斉藤 正晃, 進藤 正信, 北川 善政
    2007 年 53 巻 5 号 p. 309-313
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is a low-grade lymphoma arising not only in the stomach, but also in various nongastrointestinal sites. Clinically, MALT lymphoma behaves as an indolent disease with a prolonged clinical course, and it rarely occurs in the oral cavity. We report a case of MALT lymphoma simultaneously occurring in the palate and the right parotid gland of a 61-year-old woman.
    18F-fluorodeoxyglucose positron emission tomography (FDG-PET) has been shown to be useful for the evaluation of most types of lymphomas. However, whether FDG-PET is useful for the staging of MALT lymphoma remains controversial, because false-negative cases of low-grade malignancy have been reported. In our patient with biopsy-proven MALT lymphoma, FDG-PET revealed avid accumulation of FDG in both lesions and the right cervical lymph nodes. MALT lymphoma of stage II E was diagnosed, since no other tumor dissemination was evident. All lesions were successfully treated (complete remission) with 30 Gy of radiation therapy. There have been no signs of recurrence 18 months after treatment. The palate lesion had a higher maximum standardized uptake value (SUVmax) of 10.3 and showed more MIB-1 positive cells than the parotid lesion (SUVmax: 3.8), associated with less proliferation.
  • 望月 裕美, 小村 健, 金親 あや乃, 栢森 高, 山口 朗
    2007 年 53 巻 5 号 p. 314-318
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    Nitrogen-containing bisphosphonates are frequently administered to patients who have breast cancer with bone metastases.
    However, osteonecrosis or osteomyelitis of the jaws caused by bone exposure in the oral cavity has been recently reported as a complication of this therapy.
    We report a case of osteonecrosis of the mandible associated with nitrogen-containing bisphosphonate therapy for multiple bone metastases from breast cancer.
    A 69-year-old woman was given a diagnosis of breast cancer with metastatic disease affecting the lungs, brain, adrenal gland, and bone in 2003. She was referred to our clinic in October 2004 with a fistula that developed after extraction of the lower left second molar and paresthesia of the left side of the lower lip. Biopsy of the mandibular lesion was performed, and the histopathological diagnosis was osteonecrosis of the mandible. Although conservative therapy with antibiotics and antibacterial irrigation was administered, the lesion grew. We therefore performed sequestrectomy and rotation of the pedicled submandibular gland in December 2005.
    The postoperative course was uneventful during a follow-up period of 11 months.
    Because there is a risk of the further development of bone circulatory disturbances and osteonecrosis after surgical treatment, the treatment of choice for osteonecrosis or osteomyelitis of the jaws associated with bisphosphonate administration is conservative therapy with antibiotics and antibacterial irrigation of the lesion. When surgical treatment is required, oral surgeons should closely discuss bisphosphonate therapy with oncologists, including withdrawal and dose reductions
  • 平下 光輝, 松井 義郎, 小澤 知倫, 岩井 俊憲, 石橋 克禮, 藤内 祝
    2007 年 53 巻 5 号 p. 319-323
    発行日: 2007/05/20
    公開日: 2011/04/22
    ジャーナル フリー
    Mediastinal emphysema is a relatively rare complication of dental treatment. This paper reports a case of mediastinal emphysema arising after CO2 laser irradiation. A 48-year-old woman underwent irradiation with a CO2 laser to treat an alveolar abscess at a dental clinic. On the same day, the patient was referred to our hospital because of difficult breathing and swelling extending from the face to neck. A CT examination revealed mediastinal emphysema. The patient was hospitalized and received anti-inflammatory therapy. The swelling subsided by the 5th day, and she was discharged on the 10th day. We have to master the proper technique for treatment and recognize this complication of CO2 laser irradiation.
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