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Volume 58, Issue 11
Displaying 1-13 of 13 articles from this issue
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Preface
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[in Japanese]2012 Volume 58 Issue 11 Pages 617
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSDownload PDF (214K)
Case reports
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Hiroshi WATANABE, Kou KAWAHARA, Kou ISHII, Daisuke SANO, Hitoshi MIYAC ...2012 Volume 58 Issue 11 Pages 618-622
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSWe report a case of cytomegalovirus infection of the maxilla in a patient with malignant lymphoma. A 71-year-old woman who had received chemotherapy for malignant lymphoma for 12 years visited a local dentist because of pain in the right anterior maxilla, and apical periodontitis was diagnosed. Although she received root canal therapy and oral antimicrobial agents, her symptoms worsened, and she visited our hospital. She had a fever of 37.4℃ and swelling, redness, and spontaneous pain of the maxillary mucosa. Initial blood tests showed a leukocyte count of 2,100/mm3 and a C-reactive protein level of 34.8 mg/dL, indicating an acute inflammatory response. She was admitted and received antimicrobial agents, granulocyte colony-stimulating factor, and γ-globulin. However, necrosis of the gingiva and alveolar bone of the right anterior maxilla progressed day by day. Although a biopsy was performed on the suspected recurrence of malignant lymphoma, no malignant cells were identified. As the patient's condition improved, her symptoms subsided. However, since reinfection occurred later at the same site, curettage was performed. Histopathological examination of the curetted tissue established a diagnosis of cytomegalovirus infection. Subsequently, with the improvement of general condition, the oral symptoms also subsided.View full abstractDownload PDF (514K) -
Naohiro SHIBAYAMA, Eiji KONDO, Masatsugu YOSHIDA, Masanori TAKEKAWA, M ...2012 Volume 58 Issue 11 Pages 623-627
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSMethotrexate （MTX） is administered to patients with rheumatoid arthritis （RA） as standard treatment. Tumor necrosis factor （TNF） antagonist, which was recently approved for use in Japan, also shows excellent clinical effectiveness. However, these agents may increase the risk of malignant lymphoma. We report a case of methotrexate-associated lymphoproliferative disorder （MTX-LPD） after chemotherapy with MTX and TNF antagonists.
A 52-year-old woman presented because of pain in the left oral floor with an ulcer in June 2009. The patient had received MTX therapy for RA for 3 years since 2006, as well as TNF antagonists for 2 years from 2007. The diagnosis of‘ diffuse large B-cell lymphoma’ was established by biopsy of the focus. MTX therapy was discontinued on consultation with her doctor, and the ulcer disappeared in 4 months without any further chemotherapy for lymphoma.View full abstractDownload PDF (548K) -
Fumikazu NIMURA, Keiichi ARAKAKI, Akira ARASAKI, Shinichiro KINA, Naho ...2012 Volume 58 Issue 11 Pages 628-631
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSMyoepithelioma is a rare benign tumor that represents less than 1 % of all salivary gland tumors. We report a case of myoepithelioma developing in the mouth floor of a 72-year-old man. The lesion was clinically suspected to be a sublingual gland tumor, and resection was performed under general anesthesia. Pathologically, the tumor was composed of plasmacytoid cells that showed positive reactions for S-100 protein, keratin, and vimentin. The tumor was diagnosed pathologically as myoepithelioma. 18 months later after the operation, the postoperative course is good, with no recurrence of the tumor.View full abstractDownload PDF (531K) -
Hironori SAKAI, Hiroshi KURITA, Hiroichi KOBAYASHI, Takahiro KAMATA, S ...2012 Volume 58 Issue 11 Pages 632-636
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSLymphangioma is a benign tumor caused by the deformation of lymphatic tissues. Approximately half of all such tumors are confirmed at birth and are generally diagnosed before the early stages of childhood. The submandibular region is the most common site in the head and neck region, followed by the parotid region. Conventionally, surgical resection has been considered the best general treatment. However, treatment should be carefully selected taking into consideration the growth pattern of tumors. We describe a 50-year-old woman in whom a lymphangioma developed in the pterygomandibular space. She became aware of a swelling in the buccal region and the submandibular region several decades ago; a large quantity of yellow serous fluid was removed when aspiration of the swelling in the mouth was performed. The majority of blood components in the fluid were lymphocytes. Moreover, multiple, irregularly expanding lymphatic vessels were observed in the dermis on histological tissue examination of the swollen region. Consequently, she was given a diagnosis of lymphangioma. We report this case in which good results were obtained in response to local injection of OK432.View full abstractDownload PDF (551K) -
Tatsuyuki KONO, Yoshihiro TAKAHASHI, Mai TASHIRO, Kenji KAWANO2011 Volume 58 Issue 11 Pages 637-641
Published: April 22, 2011
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSPostoperative bleeding is a frequent complication of tooth extraction, and rupture of pseudoaneurysms formed in the extraction socket sometimes causes uncontrollable massive arterial bleeding. In this paper, we describe a case of successful hemostasis by transcatheter arterial embolization against bleeding from a pseudoaneurysm after lower third molar extraction.
The patient was a 24-year-old man who was referred to us because of arterial bleeding from the lower gingiva. He had undergone extraction of the left lower third molar by a dental general practitioner 57 days before the first visit to our hospital. Angiography revealed pooling of contrast agent in the end of a branch of the inferior alveolar artery, suggesting the rupture of a pseudoaneurysm. The branch was completely embolized with NBCA-lipiodol to achieve hemostasis. The subsequent course was uneventiful with no further bleeding, except for incomplete paralysis of the left mental nerve region, which disappeared 2 months after embolization.View full abstractDownload PDF (488K) -
Ichiro KAWAHARA, Tomohiro HAMADA, Satoshi TAKADA, Hideki KON, Takashi ...2012 Volume 58 Issue 11 Pages 642-645
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSWe report a case of a foreign body granuloma in the cheek caused by agar impression material. A 57-year-old woman was referred to our hospital because of a mass in the right cheek. The clinical diagnosis was a benign tumor. We performed tumor extirpation under local anesthesia. The enucleated preparation included a rubber-like foreign body. The histopathological diagnosis was a foreign body granuloma. Fourier transform infrared spectroscopy analysis showed that the foreign body was agar impression material. She had undergone impression taking using agar impression material immediately after tooth extraction. We concluded the foreign body granuloma was caused by aberration of agar impression material during impression taking.View full abstractDownload PDF (490K) -
Yutaka DOI, Chikako KOSHIJI, Sayaka IZUMI, Kazuhiro ASANO, Hitoshi KAW ...2012 Volume 58 Issue 11 Pages 646-650
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSWe describe a patient with tongue cancer who had hyperammonemia with impaired consciousness possibly caused by 5-fluorouracil (5-FU).
The patient, a 72-year-old-man, was given a diagnosis of tongue squamous cell carcinoma (T4N2cM0). He underwent subtotal tongue resection and bilateral neck dissection, followed immediately by reconstructive surgery with a rectus abdominis muscle flap. As postoperative adjuvant chemotherapy, a regimen of TPF was started, but 2 days later, nausea and vomiting developed, which made oral intake difficult. Six days after treatment began, he experienced disturbance of consciousness. Because of respiratory arrest during cerebral computed tomography (CT) to assess these symptoms, the patient was transferred to the intensive care unit.
On CT, no structural abnormalities of the brain were noted; however, blood testing revealed a high NH3 level of 536μg/dL. With intravenous fluid therapy, the NH3 gradually decreased, the level of consciousness improved, and the NH3 returned to within normal limits. On the basis of the treatment course and absence of liver dysfunction, the hyperammonemia was attributed to 5-FU.However, 4 months after surgery, the atient had an unexpected outcome due to pulmonary metastasis.View full abstractDownload PDF (431K) -
Natsumi TAKAMARU, Daisuke UCHIDA, Go OHE, Hirokazu NAGAI, Naozumi ISHI ...2012 Volume 58 Issue 11 Pages 651-654
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSGiant cell epulis (peripheral giant cell granuloma) is a granuloma consisting of a large number of multinucleated giant cells. Its incidence is high in Europe and the United States, but is very low in Japan. Giant cell epulis accompanied by bone formation is extremely rare in Japan. We report a case of giant cell epulis accompanied by bone formation. A 46-year-old woman visited our hospital because of a mass in the left mandibular molar region. There was a well-demarcated, pedunculated mass in the left mandibular molar region. The mass was excised under the clinical diagnosis of epulis. Histopathologically, the resected specimen consisted of spindle cells resembling fibroblasts and many multinucleated giant cells. Moreover, newly synthesized bone was observed in the center of the mass. The pathological diagnosis was a giant cell granuloma. Two years six months after the operation, there has been no evidence of recurrence.View full abstractDownload PDF (665K) -
Daisuke SANO, Kenichiro ISHIBASHI, Masayuki HIKITA, Masahiro HINOSHITA2012 Volume 58 Issue 11 Pages 655-659
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSMethotrexate (MTX) has been widely used to treat rheumatoid arthritis (RA). MTX-associated lymphoproliferative disorder (MTX-LPD) refers to lymphoid proliferation or lymphoma developing in an immunosuppressed patient who has received MTX. We report a case of MTX-LPD with gingival ulceration and jaw necrosis in a 70-year-old man who had received MTX for approximately 6 months to treat RA. The lesions were localized extranodally in the right side of the maxilla and both sides of the mandible. Biopsy specimens showed a lymphoplasmacytic infiltrate resembling diffuse large B-cell lymphoma. Immunohistochemically, Epstein-Barr virus was indentified. After withdrawal of MTX, the MTX-LPD spontaneously resolved within 4 weeks. Furthermore, some necrotic bone was naturally removed, and the exposed bone was covered by normal mucous membrane macroscopically. To date, there has been no evidence of disease recurrence.View full abstractDownload PDF (607K) -
Hirohiko TACHIBANA, Takafumi YOSHIDA, Shigeo ISHIKAWA, Hisashi OZAKI, ...2012 Volume 58 Issue 11 Pages 660-664
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSHemangioma is mostly seen in the head and neck region, particularly in the tongue and buccal mucosa. Although the mainstay of treatment for oral hemangioma is surgical excision, other therapies such as injection of sclerosant agents, laser therapy, systemic corticosteroids, and cryotherapy have also been used. Sclerotherapy is one of the most useful treatments because of its high efficacy and ability to preserve the surrounding healthy tissue. We report a large oral hemangioma treated by polidocanol sclerotherapy. After treatment, the tumor shrank and chief complaints such as biting the tongue resolved. Our results indicate that sclerotherapy with polidocanol is a safe, easy, and effective treatment for extensive oral hemangioma.View full abstractDownload PDF (502K) -
Toshihiro ARAI, Yuya DENDA, Miho TAKAHASHI, Yuki SAKAMOTO, Yusuke SATO ...2012 Volume 58 Issue 11 Pages 665-669
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSChurg-Strauss syndrome is a rare syndrom characterized by inflammation associated with bronchial asthma, eosinophilia, and necrotizing angitis involving multiple organs. The estimated number of patients reported by the Ministry of Health, Labour and Welfare research group was 450. We report a case of Churg-Strauss syndrome associated with an ulcer of the buccal mucosa.
A 79-year-old woman presented with an ulcer of the right buccal mucosa. Laboratory tests revealed, inflammatory eosinophilia. We noted ulceration of the right buccal mucosa, which showed acidocyte invasion on biopsy. The patient was admitted to the emergency room because of the difficulty in oral intake. She underwent a systemic examination and was given prednisolone (30 mg per day) from the 14th day of Churg-Straus syndrome. Esoinophilia and inflammation subsided on the 18th day, and the patient was discharged after 31 days. She now comes to the hospital routinely.View full abstractDownload PDF (819K) -
Atsushi SHUDO, Naoki TANIIKE, Yuzo HIRAI, Kyonori UEHARA, Toshihiko TA ...2012 Volume 58 Issue 11 Pages 670-674
Published: November 20, 2012
Released on J-STAGE: November 20, 2014
JOURNAL FREE ACCESSWe report a case of endoscopically assisted removal of an inverted impacted third molar near the inferior border of the mandible. A 24-year-old woman was referred for consultation concerning an impacted third molar and a radiolucent lesion of the left side of the mandible. Radiographic examination showed an inverted impacted third molar and a monolocular radiolucent lesion. The mandibular canal was situated near the buccal side of the third molar. In addition, the tip of the third molar crown was exposed from the lingual cortical bone near the inferior border of the mandible. The crown was palpable extraorally and intraorally.
The third molar and the cystic lesion were removed under general anesthesia. We chose a transoral approach because of intraoral palpability, and the operation was performed from the lingual side with endoscopic assistance. The inferior alveolar neurovascular bundle was visualized. The postoperative course was uneventful with no disturbances.View full abstractDownload PDF (993K)
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