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Volume 60, Issue 6
Displaying 1-14 of 14 articles from this issue
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Preface
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[in Japanese]2014 Volume 60 Issue 6 Pages 327
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSDownload PDF (772K)
Invited review article
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Yuichiro OHE, Tatsuya YOSHIDA2014 Volume 60 Issue 6 Pages 328-334
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSRecent advances of molecular biology have led to the development of agents that target specific molecular pathways. Epidermal growth factor receptor （EGFR） tyrosine kinase inhibitors, gefitinib, erlotinib and afatinib showed a significant high response and prolonged progression-free survival, compared withconventional cytotoxic chemotherapy in patients with non-small lung cancer （NSCLC） harboring EGFR mutations. In addition, crizotinib, inhibitor of anaplastic lymphoma kinase （ALK）, shows marked therapeutic effects against ALK rearranged NSCLC. Molecular targeted therapy selected on the basis of somatic targetable driver genes such as EGFR mutations and ALK rearrangements has been established as standard treatment for NSCLC. On the other hands, bevacizumab, a humanized anti-VEGF monoclonal antibody, in combination with first-line chemotherapy demonstrated significant clinical benefit in non-squamous NSCLC.
Recently, new somatic targetable driver gene alterations such as BRAF, ROS1, and RET has been identified, and new drugs targeting for these gene alterations are under clinical evaluation. However, the frequency of these driver gene alterations is rare in lung adenocarcinoma, and the construction of the effective screening system has been required. The nationwide screening system, Lung Cancer Genomic Screening Project for Individualized Medicine in Japan （LC-SCRUM-Japan） is ongoing. Moreover, advances in the understanding of immunology and antitumor immune responses have led to the development of new immunotherapies, including vaccination approaches and monoclonal antibodies that inhibit immune checkpoint pathways. Especially, the immune checkpoint inhibitors targeting cytotoxic T lymphocyte-associated antigen 4 （CTLA-4） and the programmed death （PD-1） pathway have shown durable and meaningful response. In the near future, molecular targeted therapy will be able to provide more benefits to many lung cancer patients.View full abstractDownload PDF (1923K)
Original article
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Takaharu TAKETOMI, Ken NAKAMURA, Moriyoshi NAKAMURA, Makoto KOGA, Osam ...2014 Volume 60 Issue 6 Pages 335-341
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSOral squamous cell carcinoma （OSCC） often metastasizes to the cervical lymph nodes, but Level V metastasis is infrequent, and the prognosis of such cases is extremely poor. We describe the clinicopathological features of Level V metastasis in patients with OSCC.
Four （1.9%） of 212 patients who underwent radical or modified radical neck dissection had histopathologically confirmed Level V metastasis. The primary site was the tongue in 1 patient, the lower gingiva in 2 patients, and the oral floor in 1 patient. Level V metastasis was associated with the mode of invasion, but not with T stage. In the patients with Level V metastasis, the mean total number of involved nodes on the affected side was 18.8, and the mean rate of conversion to positive status of the cervical lymph nodes was 49%. As for metastatic features, all patients showed metastasis to lymph nodes in the Level II region. The treatment outcome of Level V metastasis was poor, and all patients died of disease with a mean survival time of 9.3 months after neck dissection. In conclusion, although the frequency of Level V metastasis in oral squamous cell carcinoma was low, the prognosis was extremely poor. Furthermore, lymph-node metastases and extracapsular invasion in other regions appeared to be associated with Level V metastasis.View full abstractDownload PDF (2973K)
Case reports
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Eiji KONDOU, Masanori TAKEKAWA, Chizuru UTSUGI, Masatsugu YOSHIDA, Nao ...2014 Volume 60 Issue 6 Pages 342-347
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSS-1 chemotherapy is widely used to treat head and neck cancer. Reports of interstitial pneumonia as a side effect of S-1 chemotherapy are very rare.
We report a case of interstitial pneumonia possibly caused by S-1 treatment as postoperative adjuvant chemotherapy.
We gave S-1 as postoperative adjuvant chemotherapy for mandibular gingival carcinoma in a 80-year-old woman. She had a fever 53 days after starting S-1 chemotherapy. The X-ray films and computed tomography （CT） showed reticular shadows in both lung fields, and the patient was given a diagnosis of interstitial pneumonia. The results of a drug-induced lymphocyte stimulation test were positive against S-1. The total dose of S-1 until the onset of symptoms was 3360 mg. We immediately started steroid therapy and withdrew S-1 chemotherapy, and then the symptoms remarkably improved, as did the abnormal findings on CT.
In conclusion, when a patient has a high fever and dyspnea during S-1 therapy, drug-induced interstitial pneumonia should be included in the differential diagnosis.View full abstractDownload PDF (1805K) -
Akinori FUNAYAMA, Susumu SHINGAKI, Hiroyuki KANO, Takafumi HAYASHI, Ta ...2014 Volume 60 Issue 6 Pages 348-353
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSSarcoidosis is a multisystemic noncaseating epitheloid cell granulomatous disorder of undetermined etiology. It most often affects the lungs, but rarely occurs in the jaw bones. We report a case of sarcoidosis that developed in the mandible.
A 39-year-old woman was referred to our department to remove the right mandibular first molar because of severe caries. Multiple cervical lymph nodes were palpated in the right side of the neck. Impaired wound healing was noted after tooth extraction. Contrast-enhanced computed tomography （CT） demonstrated an osteolytic lesion in the right lower molar region and enlarged, homogenously enhanced lymph nodes in the right side of the neck. For systemic investigations, thoracic and abdominal CT scanning was performed. These examinations revealed bilateral pulmonary hilar, mediastinal, para-aorta, and hepatic portal lymphadenopathies. The suspected diagnosis was sarcoidosis or malignant lymphoma. Lymphadenectomy of the right cervical region and biopsy of the lesion of the mandible were performed to confirm the definitive diagnosis. Histopathologically, both specimens revealed noncaseating epitheloid cell granulomas. Thus, the final histopathological diagnosis was sarcoidosis. There was no evidence of disease progression 5 years after diagnosis.View full abstractDownload PDF (4191K) -
Shigeaki TORATANI, Akihiko SAKAMOTO, Yasushi OCHI, Mutsumi MIYAUCHI, I ...2014 Volume 60 Issue 6 Pages 354-358
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSMyxofibrosarcoma （MFS）, known previously as myxoid variant of malignant fibrous histiocytoma （myxoid MFH）, was reclassified to the category of fibroblastic/myofibroblastic tumors in 2002. MFS is defined as a malignant fibroblastic lesion with a variably myxoid stroma, pleomorphism, and a distinctively curvilinear vascular pattern. This lesion is one of the common soft tissue sarcomas, usually arising in the subcutaneous tissue of the limbs in elderly patients, but very rarely occurring in the head and neck region.
We report a case of MFS in the maxilla. A 39-year-old man visited our hospital because of an asymptomatic mass arising in the left side of the maxilla. Although an incisional biopsy specimen was initially diagnosed as odontogenic myxoma, histopathological and immunohistochemical analyses of the resected specimen finally suggested that the lesion was a MFS/myxoid MFH. There has been no evidence of local recurrence or metastasis as of 5 years after surgery.View full abstractDownload PDF (3015K) -
Gen SHIMIZU, Hirohisa CHISOKU, Yusei FUJITA, Yoshiyuki OTA, Itsuro KAT ...2014 Volume 60 Issue 6 Pages 359-364
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSSeptic pulmonary embolism （SPE） is a rare but serious infectious disorder. Clinically, SPE is associated with easily documented infections, such as bacterial endocarditis, septic thrombophlebitis, and infected central venous catheters. Odontogenic infection is a rare cause of SPE. We report on a 59-year-old man who visited our hospital because of right mandibular swelling and dysphagia. The diagnosis was a perimandibular abscess due to inflammation of a tooth extraction wound. Since the patient lost consciousness after admission to our hospital, urgent intratracheal intubation was performed. Chest computed tomography showed multiple nodular shadows with features characteristics of SPE. Blood examination revealed diabetes mellitus and disseminated intravascular coagulation （DIC）. Blood culture failed to detect causative bacteria. Antimicrobial agents combined with drainage of the perimandibular abscess were a successful treatment. Odontogenic infection is considered a possible source of SPE.View full abstractDownload PDF (1929K) -
Yuuki AKIMOTO, Masayoshi MIYASAWA, Hiroki MIYATE, Tatsuru IKEDA2014 Volume 60 Issue 6 Pages 365-369
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSWe report a case of sinusitis caused by the displacement four interdental brushes into the maxillary sinus. A 73-year-old man was referred to our department to receive consultation for a strange feeling in the gingiva of the left maxillary first molar during hospitalization for an inguinal hernia operation. On intraoral examination, a spiral metal wire was confirmed in the distal side of left maxillary first molar. A computed tomographic scan showed a high density shadow and four metal-like images in the left maxillary sinus. We performed radical surgery for maxillary sinusitis and removed the foreign bodies under general anesthesia. The four foreign bodies were the distal ends of broken interdental brushes. Histopathological examinations revealed severe inflammatory cell infiltration of the maxillary mucosa and a perforation that was apparently caused by the interdental brush. After operation, we instructed the patient on the proper usage of interdental brushes, and there has been no sign of inflammation of the maxillary sinus.View full abstractDownload PDF (5632K) -
Mariko NAKAMURA, Makoto KOGA, Machiko HARADA, Takahiro HARAGUCHI, Osam ...2014 Volume 60 Issue 6 Pages 370-374
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSRenal cell carcinoma （RCC） is infamous for unpredictable metastasis. This report describes a possible case of metastatic RCC to the mandible 26 years after nephrectomy. A 71-year-old woman was referred to our hospital because of hypoesthesia of the right submental region and a granulomatous mass arising in the right mandibular mucosa. The patient had undergone a right nephrectomy for clear cell carcinoma 26 years previously. Biopsy of the oral lesion revealed clear cell carcinoma, but whether the tumor was of oral origin or a metastasis could not be confirmed histopathologically. Furthermore, no other tumor mass was identified on evaluation of the entire body by FDG-PET scanning. The patient underwent a segmental mandibulectomy, radical neck dissection, and radiotherapy with a total dose of 60 Gy. Six months later, computed tomography revealed masses in the left kidney, mediastinum, retroperitoneum, pancreas, and the right primary nephrectomy region which were diagnosed as metastases from RCC. Finally, the mandibular lesion was considered to be a metastatic renal cell carcinoma. The patient received interferon, but died of the growing metastatic tumor.View full abstractDownload PDF (2579K) -
Hitoshi MIYACHI, Norio KUROYANAGI, Shigeki OCHIAI, Noboru KAMIYA, Kazu ...2014 Volume 60 Issue 6 Pages 375-379
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSA 21-year-old woman presented with maxillary protrusion and a gummy smile along with mandibular retrognathism. Moreover, an arch width discrepancy was observed between the maxilla and the mandible. After 10 months of presurgical orthodontic treatment using a multibracket appliance, multi-segment Le Fort I osteotomy and sagittal split ramus osteotomy were performed. In the maxilla, the upper first premolars were extracted, and subsequently the upper arch was divided with a piezoelectric device into 4 segments after a down fracture. The anterior maxillary segment was moved distally to close the space, and the posterior maxillary segments were moved laterally to correct the excessively narrow maxilla. After 3 months of postsurgical orthodontic treatment, a favorable facial profile and occlusal relationship were obtained. The total treatment period was 13 months. A multi-segment Le Fort I osteotomy greatly contributed to shortening the duration of therapy for arch width discrepancy between the maxilla and the mandible. These results suggest that piezosurgery might be effective and safe for multi-segment Le Fort I osteotomy.View full abstractDownload PDF (2115K) -
Hideaki ASAI, Hiroko HAGINO, Kanae SATOH, Keiji ISHIGURO, Minoru UEDA2014 Volume 60 Issue 6 Pages 380-383
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSDislocation of the mandibular condyle into the cranial fossa after injury is rare, with few reports.
We report the case of a 17-year-old girl who was injured in a bicycle accident. We found that computed tomography was reliable for diagnosing condyle dislocation into the cranial fossa. Surgery was performed under general anesthesia. After 8 months’ follow-up, there remained a slight disturbance of mouth opening and deviation to the right on maximum opening.View full abstractDownload PDF (1861K) -
Takahito MATSUE, Kikuo TAKAHASHI2014 Volume 60 Issue 6 Pages 384-388
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSIntravascular papillary endothelial hyperplasia （IPEH）, known as Masson’s tumor, is a rare benign non-neoplastic vascular lesion of the skin and subcutaneous tissue, consisting of a reactive proliferation of endothelial cells with papillary formations related to a thrombus. Presentation in the oral cavity is rare.
A 40-year-old woman was referred to our hospital because of tongue swelling. Physical examination revealed a movable hemispherical nodule measuring 25 × 20 mm on the right side of the dorsum of the tongue. The mucosa of the lesion was dark red. The lesion was clinically diagnosed as a hemangioma and was surgically removed under general anesthesia. Histological examinations indicated that the lesion was IPEH. Limited information is obtained on magnetic resonance imaging （MRI） of oral IPEH because of the lesion is generally too small to examine. However, because our patient had the largest case of IPEH developing in the oral cavity, it was possible to compare MRI findings with histologic features.View full abstractDownload PDF (18321K) -
Hiroshi NOZAWA, Shinya WATANABE, Tomohiro TAKAYAMA, Syuri HADA, Junko ...2014 Volume 60 Issue 6 Pages 389-393
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSIn this paper, we describe our experience with a patient who had an intramuscular lipoma in the right side of the mental region. A man aged 81 years who had a history of a right-sided mental mass since 2002 was referred to our department by a dental clinic because of a gradual increase in lesion size. An elastic soft mass with a distinct boundary, measuring 18 × 15 mm, was palpable. In the oral cavity, it was also palpable within the premolar buccal mucosa. The color of the surface membrane was normal. Both T1 and T2-weighted magnetic resonance imaging showed high intensity. The mass was resected under local anesthesia for the diagnosis of a benign tumor, and the histopathological diagnosis was intramuscular lipoma. There have been no signs of recurrence during follow-up as of 1 year 8 months after surgery.View full abstractDownload PDF (1784K) -
Kyohei YOSHIKAWA, Kazuma NOGUCHI, Michiyo YAMAMURA, Kazuki TAKAOKA, Ku ...2014 Volume 60 Issue 6 Pages 394-398
Published: June 20, 2014
Released on J-STAGE: June 23, 2015
JOURNAL FREE ACCESSImpacted supernumerary teeth are frequently found on panoramic X-ray examination and generally arise in the anterior region of the maxilla. Few impacted supernumerary teeth in the canine and premolar region have been reported. Although patients with a genetic disorder sometimes have multiple impacted supernumerary teeth, it is rare for patients without a genetic disorder to have multiple impacted supernumerary teeth. We report a rare case of eight impacted supernumerary teeth in the bimaxillary canine and premolar region that occurred symmetrically in a 16-year-old boy. The number of supernumerary teeth in our patient was eight. We believe that this is the largest number of supernumerary teeth in a Japanese patient without a genetic disorder to be reported.View full abstractDownload PDF (1512K)
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