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62 巻, 3 号
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新崎 章2016 年 62 巻 3 号 p. 109
発行日: 2016/03/20
公開日: 2016/05/26
ジャーナル フリーPDF形式でダウンロード (592K)
症例報告
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木本 奈津子, 大亦 哲司, 木本 栄司, 福山 瑛子, 森田 祥弘, 森田 展雄2016 年 62 巻 3 号 p. 110-114
発行日: 2016/03/20
公開日: 2016/05/26
ジャーナル フリーSchwannoma is a rare benign tumor arising in the head and neck region. Many schwannomas occurring in the oral cavity are relatively small, and nearly all reports have described tumors less than 20-30 mm in diameter. Schwannomas tend to undergo secondary changes such as cyst formation, hemorrhage, hyalinization, and mucoid deposition over a prolonged period. Some schwannomas display marked nuclear atypia and are referred to as ancient schwannomas. This report describes a hypervascular ancient schwannoma more than 40 mm in diameter that arose from the floor of the mouth. The tumor was located on the side of oral floor inside the mylohyoid muscle. The tumor displaced this muscle inferiorly, resulting in marked swelling of the submandibular region, but little swelling of the floor of the mouth. The tumor was surgically removed using an extraoral approach, because of the high risk of bleeding and marked swelling of the submandibular region. No signs or symptoms of recurrence have been noted as of 4 years postoperatively.抄録全体を表示PDF形式でダウンロード (567K) -
井上 博貴, 阿知波 基信, 竹本 隆2016 年 62 巻 3 号 p. 115-119
発行日: 2016/03/20
公開日: 2016/05/26
ジャーナル フリーImmunoglobulin A (IgA) pemphigus is an autoimmune bullous disease with IgA deposition between epidermal cells. A 43-year-old man visited our department because of an eating disorder caused by tongue pain. He had a history of hepatic steatosis, and there was no remarkable family history. Seven days after presentation, herpetic stomatitis spread throughout the gum area, and he was hospitalized. Seven days after admission, folliculitis-like findings were noted in the chest, abdomen, back, and trunk, accompanied by clinically significant skin folliculitis in both groin areas. Therefore, Behcet's disease was suspected. He was referred to the department of dermatology, and a pathological biopsy of the groin area was performed on the same day. A direct immunofluorescence test was positive for anti-epidermal cell membrane antibodies (IgA). The patient was therefore given a diagnosis of IgA pemphigus. Prednisolone was administered orally, and the intraoral symptoms improved 12 days after hospitalization. Subsequently, the generalized folliculitis improved 17 days after hospitalization, and he was discharged from the hospital.抄録全体を表示PDF形式でダウンロード (660K) -
田中 庸子, 郷家 久道, 河原田 尚, 和気 昌弘, 中谷 逸希, 濱田 良樹2016 年 62 巻 3 号 p. 120-123
発行日: 2016/03/20
公開日: 2016/05/26
ジャーナル フリーChoristoma is a tumor-like mass that has lost continuity with the original normal tissue and develops in an ectopic position for some reason. In particular, osteocartilaginous choristomas containing normal cartilage and bone tissue are extremely rare, and no cases of osteocartilaginous choristoma developing in the lower lip have been reported. We describe a 68-year-old woman who had been referred to our clinic because of a painless mass in the right lower lip. Macroscopic examination revealed a submucosal mass lesion with a well-defined border and measuring approximately 24× 21× 19 mm. It was a pedunculated, movable, elastic hard mass. Magnetic resonance imaging (MRI) showed a well-defined mass above the orbicularis oris muscle. The lesion showed regions of isointense signal intensity with spots of high signal intensity on T1-weighted images and low signal intensity with heterogeneous areas of high signal intensity on T2-weighted images. A pleomorphic adenoma of the lower lip was diagnosed on the basis of clinical course, clinical findings, and MRI findings. Surgical excision (excisional biopsy) of the tumor was performed with the patient under general anesthesia. Histopathological examination led to the definitive diagnosis of an osteocartilaginous choristoma. No signs of recurrence have been noted as of 3 years after surgery.抄録全体を表示PDF形式でダウンロード (522K) -
林田 悠, 武富 孝治, 原田 真知子, 古場 朗洋, 田上 隆一郎, 楠川 仁悟2016 年 62 巻 3 号 p. 124-128
発行日: 2016/03/20
公開日: 2016/05/26
ジャーナル フリーSchwannoma, an ectodermal tumor arising from Schwann cells, occasionally occurs in the oral and maxillofacial region. We report a case of schwannoma arising in the lingual nerve. The patient was a 53-year-old man who came to our hospital with a chief complaint of a swelling, an elastic soft and movable painless mass that was palpated in the right submandibular region. Magnetic resonance imaging revealed a well-defined, multilocular and lobular tumor pushing the right mandibular gland dorsally. It showed high intensity on T1-weighted images and heterogeneous high intensity on T2-weighted images. Schwannoma was diagnosed on needle biopsy. In December 2013, tumor resection with concurrent resection of the right submandibular gland and sublingual gland was performed with the patient under general anesthesia. Because the tumor was contiguous with the lingual nerve, the lingual nerve was sacrificed. Histopathological examination revealed Antoni A and B mixed type schwannoma.抄録全体を表示PDF形式でダウンロード (610K) -
今田 光彦, 柳生 貴裕, 中上 佳寿彦, 上山 善弘, 桐田 忠昭2016 年 62 巻 3 号 p. 129-133
発行日: 2016/03/20
公開日: 2016/05/26
ジャーナル フリーKasabach-Merritt syndrome is a coagulation disorder caused by hemangioma, usually resulting in chronic disseminated intravascular coagulation (DIC). We report a case of post-extraction hemorrhage with Kasabach-Merritt syndrome. A 54-year-old man was referred to our department because of persistent hemorrhage after extraction of the left lower first molar. Although we performed local hemostatic treatment, intermittent hemorrhage persisted. Blood examination revealed abnormal coagulation, and the patient had a medical history of giant hemangioma of the liver. We therefore suspected post-extraction hemorrhage caused by Kasabach-Merritt syndrome and consulted with a hematologist. The patient was given a diagnosis of Kasabach-Merritt syndrome and received camostat mesilate. We continued local hemostatic treatment, and hemostasis was successfully achieved. About 10% of patients with hemangioma of the liver have Kasabach-Merritt syndrome. In patients with hemangioma who have abnormal bleeding such as post-extraction hemorrhage, the possibility of chronic DIC should be included in the differential diagnosis.抄録全体を表示PDF形式でダウンロード (559K) -
松永 和秀, 濱田 傑, 松本 幸三, 岐部 俊郎, 久米 健一, 中村 典史2016 年 62 巻 3 号 p. 134-138
発行日: 2016/03/20
公開日: 2016/05/26
ジャーナル フリーProgressive hemifacial atrophy is a disease in which the soft and hard tissues of the unilateral trigeminal nerve domain progressively degenerate. We describe our experience with a patient with unilateral lip atrophy due to progressive hemifacial atrophy who underwent unilateral reconstruction of the upper lip. The patient was a 22-year-old woman. She had difficulty closing her mouth due to the unilateral lip atrophy. We performed reconstruction of the upper lip on the atrophic side with a cross-lip vermilion flap of the non-atrophic lower lip and released the flap 14 days postoperatively. Viability of the flap was favorable postoperatively. Slight drooping of the upper lip on the affected side gradually developed after the operation. Subsequently, we performed minor correction of the upper lip on the affected side 5 months postoperatively. Atrophy and deformity of the upper lip on the affected side were not evident, and the form of the lip and function of lip closure on the affected side were satisfactory 2 years postoperatively. To correct the form and function in the presence of upper lip atrophy, the use of a cross-lip vermilion flap of the non-atrophic lower lip could become a useful technique for reconstruction.抄録全体を表示PDF形式でダウンロード (548K)
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