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61 巻, 4 号
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巻頭言
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今井 裕2015 年 61 巻 4 号 p. 203
発行日: 2015/04/20
公開日: 2015/10/06
ジャーナル フリーPDF形式でダウンロード (872K)
原著
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徳宮 元富, 中原 寛和, 松岡 裕大, 内橋 俊大, 栗本 聖之, 古郷 幹彦2015 年 61 巻 4 号 p. 204-211
発行日: 2015/04/20
公開日: 2015/10/06
ジャーナル フリーThe degradation of extracellular matrix (ECM) is one of the most important processes in invasion and metastasis by malignant tumor cells. Reptin is a known component of the chromatin remodeling complex that has been reported to repress expression of the metastasis suppressor gene and hence regulates invasion and metastasis by malignant tumor cells. In this study, using two cell lines derived from human oral squamous cell carcinomas, OSC-19 and OSC-20, we demonstrated that knockdown of the reptin gene promoted mobility, changed the shape of the cells from oval to spindle-like, suppressed the expression of E-cadherin (an epithelial marker), and promoted the expression of N-cadherin (a mesenchymal marker). These results suggest that reptin regulates the invasiveness of tumors cells into the ECM by participating in epithelial-mesenchymal transition (EMT).抄録全体を表示PDF形式でダウンロード (1088K)
症例報告
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逢坂 竜太, 内田 育宏, 大山 定男, 宮下 英高, 河合 繁夫, 柴原 孝彦2015 年 61 巻 4 号 p. 212-216
発行日: 2015/04/20
公開日: 2015/10/06
ジャーナル フリーLarge cell neuroendocrine carcinomas (LCNEC) are relatively rare tumors that arise in various organs. We report a case of primary LCNEC of the tongue.
A 60-year-old man was referred to our department because of impaired swallowing function due to pain while eating, as well as an ulcer on the left side of the tongue. Squamous cell carcinoma was suspected on biopsy. A whole-body examination showed no evidence of metastasis. Therefore, the patient was given a clinical diagnosis of squamous cell carcinoma of the left side of the tongue suspected (cT4aN2bM0: Stage IVa). After preoperative chemotherapy, we performed a tracheostomy, bilateral neck dissection, complete removal of the tongue, and reconstructive surgery using a rectus abdominis free flap, with the patient under general anesthesia.
Histologically, the tumor was composed of solid nests of atypical large cells. Necrosis was remarkable. Tumor nests showed peripheral palisading and rosette formation. Immunohistochemically, the cancer cells were positive for chromogranin A and synaptophysin. We diagnosed this tumor as LCNEC, based on the criteria established for pulmonary tumors. The patient is alive without recurrence or metastasis 55 months after surgery.
Since LCNEC is exceptionally rare in the head and neck region, especially in the oral cavity, the prognosis was unclear, and treatment has not been established. Hence, studies of further cases are required to establish adequate treatment for LCNEC of the head and neck region.抄録全体を表示PDF形式でダウンロード (1070K) -
新井 直也, 冨原 圭, 武井 理恵, 能登 善弘, 和田 重人, 野口 誠2015 年 61 巻 4 号 p. 217-221
発行日: 2015/04/20
公開日: 2015/10/06
ジャーナル フリーSebaceous carcinoma is a malignant tumor mainly arising from sebaceous gland cells of the eyelids. This tumor develops very rarely in the oral region and has not been reported in the lower lip. We report a case of sebaceous carcinoma arising in the lower lip. A 61-year-old man had a painless tumor of the lower lip. A well-defined 15-mm elastic hard mass was palpable in the subcutaneous tissue. A biopsy was performed because of recent rapid growth of the lesion, resulting in a diagnosis of sebaceous carcinoma, and the tumor was surgically resected. Microscopically, a solid tumor showing invasive growth was seen directly under the squamous epithelium of the vermilion and in deeper regions. The tumor nests consisted of pleomorphic dyskaryotic cells. Some of the tumor cells possessed vacuolar cytoplasm, and a small proportion of vacuoles were positive for fat staining. Immunohistochemically, the tumor cells expressed EMA, CAM5.2, CK5/6, CK7, CK14, CK34 β E12, and p63, but not s-100, CD10, calponin, or SMA. On the basis of the above results, the lesion was diagnosed as sebaceous carcinoma. During about 2 years of postoperative follow-up, there has been no evidence of recurrence or metastasis. Long-term follow-up is mandatory because of the unpredictable prognosis of oral sebaceous carcinoma.抄録全体を表示PDF形式でダウンロード (981K) -
杉山 円, 森 良之, 末永 英之, 西條 英人, 小笠原 徹, 星 和人2015 年 61 巻 4 号 p. 222-226
発行日: 2015/04/20
公開日: 2015/10/06
ジャーナル フリーNon-Hodgkin's lymphoma is associated with a potential risk of multiple primary carcinoma. Immune suppression related to this disease or the treatment applied has been suggested to cause multiple primary carcinoma. Therefore, appropriate follow-up and management are essential. We report a case of mucoepidermoid carcinoma of the minor salivary gland of the palate that developed after chemotherapy, total-body irradiation, and allogenic bone marrow transplantation for non-Hodgkin's lymphoma 16 years previously. A-32-year-old woman was referred to our hospital because of a painless mass arising in the right side of the palate, which she had recognized 5 years previously. She had received high-dose chemotherapy, total-body irradiation, and allogenic bone marrow transplantation at 16 years of age for non-Hodgkin's lymphoma. She had remained d isease-free for 16 years. An excisional biopsy was performed with the patient under general anesthesia, and the pathological diagnosis during surgery was low-grade mucoepidermoid carcinoma. The resected region was thus extended. Neither recurrence nor metastasis has occurred as of 22 months after surgery.抄録全体を表示PDF形式でダウンロード (965K) -
緒方 絹子, 岩本 修, 高野 雅代, 轟 圭太, 古場 朗洋, 楠川 仁悟2015 年 61 巻 4 号 p. 227-231
発行日: 2015/04/20
公開日: 2015/10/06
ジャーナル フリーOyama et al.1) reported that age-related Epstein-Barr virus (EBV) -associated B-cell lymphoproliferative disorder (age-related EBV + B-LPD) is a group of clinicopathological entities that predominantly occur in elderly patients and share features of EBV-positive and B-cell neoplasms, arising in immunologically compromised patients despite no evidence of predisposing immunodeficiency. This disease may be associated with an age-related decline in immune function, and the 2008 WHO lymphoma classification now includes EBV-positive diffuse large B-cell lymphoma of the elderly as one subtype of diffuse large B-cell lymphoma (DLBCL). We report a case of the disease arising in the left submandibular region. A 79-year-old man was admitted our hospital because of swelling and pain of the left submandibular region as well as a hoarse voice. We suspected carcinoma of the left submandibular glands or malignant lymphoma on the basis of the laboratory data and imaging findings, and performed an incision biopsy. Histopathologically, infiltration of large atypical lymphoid cells into granulation tissue with marked necrosis was found in the cervical lymph nodes. The neoplastic cells were positive for CD20, CD30, and EBER and negative for CD3 and CD15. Therefore, the patient was given a diagnosis of age-related EBV + B-LPD. He received radiotherapy and target therapy and had remission.抄録全体を表示PDF形式でダウンロード (1110K) -
東郷 拓也, 白井 朋之, 栗原 絹枝, 野口 沙希, 酒井 克彦, 片倉 朗2015 年 61 巻 4 号 p. 232-236
発行日: 2015/04/20
公開日: 2015/10/06
ジャーナル フリーToxic shock-like syndrome induces rapidly progressive necrotizing fasciitis, shock, and multiple organ failure. It can be fatal, with a mortality rate of 30% to 40%. Group A β -hemolytic streptococci are the causative bacteria. However, in recent years, some infections due to non-group A streptococci have been reported.
The patient was a 39-year old man. We confirmed abscess formation at the base of the mouth, and an antiinflammatory operation was conducted with the patient under general anesthesia. Shock developed 4 hours after the operation. The chest radiograph revealed bilateral pulmonary infiltrative shadows, and the patient was given a diagnosis of acute respiratory distress syndrome on the basis of findings of hypoxemia. The patient also had abnormal coagulation due to disseminated intravascular coagulation, elevated total bilirubin levels due to liver failure, and soft tissue necrosis in the left submandibular and buccal regions. Non-group A streptococci were identified in the blood culture and closed pus.
Through the cooperation of all associated departments, the patient recovered from shock and survived.抄録全体を表示PDF形式でダウンロード (944K) -
川上 哲司, 堀田 聡, 上田 順宏, 今井 裕一郎, 高嶌 森彦, 桐田 忠昭2015 年 61 巻 4 号 p. 237-240
発行日: 2015/04/20
公開日: 2015/10/06
ジャーナル フリーPsoriatic arthritis is a specific type of inflammatory arthritis that develops in 10% to 30% of patients with psoriasis. It involves peripheral joints and lumbar vertebrae, and is characterized by enthesitis, i.e., inflammation at sites of tendon attachments to bone. In this study, we describe a patient with psoriatic arthritis who had temporomandibular joint ankylosis with markedly limited mouth opening and underwent surgery.
The patient was a 42-year-old man. He was referred to our department by a dermatological clinic because of limited mouth opening. The patient had a reduced mouth opening distance, and temporomandibular arthralgia developed. He also had a past history of psoriatic erythroderma. The maximum mouth opening was 3 mm, suggesting markedly limited mouth opening. Imaging studies showed bilateral narrowing of the joint spaces, frozen joints, and elongated coronoid processes. The patient was given a diagnosis of temporomandibular joint ankylosis, and bilateral condylectomy and aponeurectomy of the masseter muscle with coronoidectomy to release the temporal muscle tendon were performed by Piezosurgery ® with the patient under general anesthesia. The maximum mouth opening increased to 23 mm after condylectomy, 35 mm after right coronoidectomy and aponeurectomy, and 55 mm (final maximum mouth opening) after left coronoidectomy and aponeurectomy. After surgery, mouth opening training was actively performed. Limited mouth opening was improved without complications, and the jaw function was good. The postoperative course was satisfactory.抄録全体を表示PDF形式でダウンロード (893K) -
櫻井 拓真, 吉賀 大午, 宮本 郁也, 森山 雅文, 中村 誠司, 高橋 哲2015 年 61 巻 4 号 p. 241-245
発行日: 2015/04/20
公開日: 2015/10/06
ジャーナル フリーFibrodysplasia ossificans progressiva (FOP) is a rare hereditary disease characterized by heterotopic ossification of skeletal muscles, tendons, and ligaments. In the oral and maxillofacial region, FOP leads to eating disorders caused by a limited range of mouth opening. At a late stage, respiratory function is impaired by limited movement of the thorax. We reported a rare case of FOP with trismus and discuss the related literature. A 28-year-old woman was referred to our hospital because of trismus in December 2011. She had heterotopic ossification in the left scapula and was given a diagnosis of FOP at the age of 17 years. Extraoral examination showed temporary pain extending from the left temporomandibular joint to the buccal region when she opened the mouth. A maximal mouth opening of 3 mm was confirmed. Intraoral examination showed an inflammatory reaction at the gingiva of the maxillary left third molar. Magnetic resonance imaging showed high intensity of the left lateral pterygoid muscle. Nonsteroidal anti-inflammatory drugs and injectable bisphosphonates were administered, followed by mouth opening training. Her maximal mouth opening markedly improved to 22 mm 1 year after initial presentation, without any recrudescence.抄録全体を表示PDF形式でダウンロード (892K) -
軽部 健史, 加藤 伸, 高森 康次, 長谷川 稔洋, 池内 忍, 河奈 裕正2015 年 61 巻 4 号 p. 246-250
発行日: 2015/04/20
公開日: 2015/10/06
ジャーナル フリーA calcifying epithelial odontogenic tumor (CEOT) is a relatively rare benign odontogenic tumor, which was described by Pindborg in 1958. According to the 2005 World Health Organization Classification of Odontogenic Tumors, cystic changes are not seen macroscopically in CEOT. We report a case of cystic variant of CEOT arising in the maxilla.
The patient was a 19-year-old woman who had a swelling on the right side of the face, and she was referred to our department. The panoramic X-ray film showed a nearly circular radiolucent image in the upper right canine region with impacted teeth. Computed tomography revealed a nearly circular radiolucent soft tissue shadow, which was associated with impacted teeth and many calcified bodies. The subcutaneous soft tissue in the right cheek showed low signal intensity on T1-weighted images and high signal intensity on T2-weighted images on magnetic resonance imaging. We performed extraction and tumorectomy with the patient under general anesthesia, and the tumor appeared to be a cyst macroscopically. The histopathological diagnosis was cystic variant of CEOT. There have been no signs of recurrence during follow-up as of 1 year 6 months after surgery.抄録全体を表示PDF形式でダウンロード (977K)
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