Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 63, Issue 11
Displaying 1-11 of 11 articles from this issue
Preface
Invited review article
  • Noboru YAKUSHIJI, Nobuhiro TAGUCHI, Kenro HORI, Tomohiro YAMAUCHI, Yos ...
    2017 Volume 63 Issue 11 Pages 534-545
    Published: November 20, 2017
    Released on J-STAGE: January 22, 2018
    JOURNAL FREE ACCESS

    Advances in medical treatment and demographic change due to aging have made dentistry and oral surgery medical care significant change. In point of the future dental care in Japan, hospital dentistry and oral surgery improves the quality of treatment and the patient's safety and secure. In addition, it is believed to contribute to make the role of hospital dentistry and oral-maxillofacial surgery in the integrated community healthcare system and the positioning of dentistry in future medical policy.

     It is known fact that the need for hospital dentistry and oral surgery will increase in future dental care.

     At the same time this was believed to contribute significantly to improve the quality of local dental care and hospital dental oral surgery.

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Case reports
  • Keisuke MORI, Shoko TSURUOKA, Reona AIJIMA, Daiji SHIMOHIRA, Atsushi D ...
    2017 Volume 63 Issue 11 Pages 546-551
    Published: November 20, 2017
    Released on J-STAGE: January 22, 2018
    JOURNAL FREE ACCESS

    Ameloblastic fibromas are rare benign tumors that typically form in the mandibles of males under 20 years of age. According to the World Health Organization classification of 2005, ameloblastic fibromas are odontogenic epithelial tumors with ectomesenchyme that form in the absence of hard tissue. Here, we report a case of ameloblastic fibroma in a 3-year-old female infant with a cystic lesion within the right maxilla. Computed tomographic images revealed that the cystic lesion was mixed with a solid lesion. A biopsy and fenestration of the lesion were performed, and microscopic evaluation revealed that the histopathological tissue pattern was a dentigerous cyst. Four months postoperatively, tumoral lesions developed in the region of fenestration and a second biopsy was performed. The histopathological diagnosis was an ameloblastoma, for which enucleation was performed. Additional histopathological analyses identified the tissue as an ameloblastic fibroma, which was initially difficult to diagnose because it was a mixed tumor consisting of epithelial and mesenchymal components. In our patient the lesion had a complex structure, which most likely also contributed to the discordance among the three histopathological diagnoses. There has been no sign of recurrence in the 5 years after the operation.

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  • Juri MURAKAMI, Kiyohide ISHIHATA, Etsuro NOZOE, Kouzou MATSUMOTO, Kaor ...
    2017 Volume 63 Issue 11 Pages 552-557
    Published: November 20, 2017
    Released on J-STAGE: January 22, 2018
    JOURNAL FREE ACCESS

    Methotrexate (MTX) has been recognized as a first-line treatment for rheumatoid arthritis (RA) because of its ability to reduce the proliferation of innate immune cells. Recently, the occurrence of methotrexate-associated lymphoproliferative disorders (MTX-LPD) in the oral cavity has been reported. We describe a case of MTX-LPD associated with asynchronous ulcers in the oral and skin regions that was diagnosed by oral lesions. A 79-year-old man had been receiving MTX for over 7 years as a treatment for RA. Two years earlier, a skin ulcer had developed in the lumbar region, which histopathologically diagnosed as a sarcoma, and he was treated with heavy-ion radiotherapy. Before he presented to our institution, he had severe bilateral gingival pain in the mandibular molar region for 2 months. The oral lesions appeared to be necrotic ulcers, and a pathological examination revealed lymphocytic infiltration involving atypical cells. Based on the patient's medical history and the results of a histopathological reexamination of the skin lesions, both the oral and skin lesions were diagnosed as MTX-LPD. Although the gingival lesions expanded over the next few weeks, the ulcers spontaneously disappeared after MTX treatment was withdrawn. There have been no signs of recurrence for 2 years.

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  • Toshimitsu OHSAKO, Yuta IMAI, Sho MATSUKAWA, Kaori MOCHIDA, Hiroyuki H ...
    2017 Volume 63 Issue 11 Pages 558-563
    Published: November 20, 2017
    Released on J-STAGE: January 22, 2018
    JOURNAL FREE ACCESS

    A 59-year-old woman was referred to our department in May 2014 because of a right mandibular gingival mass. Examination of the right mandibular gingiva revealed a black hemorrhagic lesion with ulceration measuring 23×19 mm. The biopsy results were consistent with a diagnosis of malignant melanoma. The patient was treated with one course of preoperative DAV therapy (dacarbazine, nimustine, vincristine), following which a classical radical neck dissection (RND) with segmental mandibulotomy and reconstruction using a tongue flap and iliac bone were performed in July 2014. The patient was subsequently given four postoperative courses of DAV-Feron therapy (dacarbazine, nimustine, vincristine, interferon-β). On reexamination in October, the patient had elevated levels of 5-S-cysteinyldopa (CD), and treatment with nivolumab was therefore initiated. The treatment successfully reduced the 5-S-CD levels. In February 2015, the patient was given a diagnosis of recurrent melanoma under the right buccal mucosa and underwent surgical resection of the tumor in May 2015. No signs of recurrence or metastasis were evident 26 months after surgery. Based on the histological therapeutic effect observed in the resected specimen, we concluded that nivolumab is an effective treatment for malignant melanoma of the mandibular gingiva.

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  • Yoshito KOYAMA, Eiji KONDO, Takahiro KAMATA, Shin-ichi YAMADA, Hiroshi ...
    2017 Volume 63 Issue 11 Pages 564-569
    Published: November 20, 2017
    Released on J-STAGE: January 22, 2018
    JOURNAL FREE ACCESS

    A quarter of extranodal lymphomas occur in the head and neck region, and definitive diagnosis is sometimes difficult. Here, we report a case of peripheral T-cell lymphoma arising in the region of the masseter muscle in a patient with sarcoidosis. A 74-year-old man with a medical history of prostate cancer and sarcoidosis complained of swelling of the right masseter muscle. A soft indurative mass measuring 40 mm was palpated around the right masseter muscle. T2-weighted magnetic resonance imaging revealed a diffuse high signal mass in the region of the masseter muscle. We suspected sarcoidosis and planned a biopsy, but the swelling resolved spontaneously. One month later, the lesion reappeared. Thereafter, an open biopsy of the lesion was performed, and a histopathological diagnosis of suspected T-cell lymphoma was made. Reconstructed clonality analysis of the T-cell receptor γ chain region gene revealed reproducible T-cell monoclonality, and a final diagnosis of peripheral T-cell lymphoma not otherwise specified was made. The patient received four courses of CHOP therapy and has been followed up for 10 months after the treatment without any signs of recurrence. We guessed that the disease might have been caused by immunodeficiency due to long-term steroid therapy in this patient.

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  • Hideyuki NAKASHIMA, Toshinori IWAI, Shuhei MINAMIYAMA, Kei WATANUKI, K ...
    2017 Volume 63 Issue 11 Pages 570-575
    Published: November 20, 2017
    Released on J-STAGE: January 22, 2018
    JOURNAL FREE ACCESS

    Langerhans'-cell histiocytosis (LCH) is a rare proliferative disorder in which Langerhans'cells (LCs) accumulate in various organs. This report describes a rare case with multisystem LCH involving the mandible, lung, and femur in a 37-year-old man. He was referred to our department because of poor healing of the tooth extraction socket of the right mandibular first molar. We performed a biopsy of the lesion and obtained a histopathologic diagnosis of LCH. The right molar lesion of the mandible was removed by surgical curettage, and smoking cessation therapy was performed for the pulmonary lesion. Although neither lesion recurred, a novel lesion developed on the right side of the femur approximately 2 years after the initial treatment. To treat the recurrent lesion, surgical curettage and bone grafting were performed. The patient has shown no evidence of disease for 2 years after the second treatment. Nevertheless, long-term follow-up is necessary given the local recurrence and transformation into multifocal disease.

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  • Miho TAKAHASHI, Taiki SUZUKI, Yuji HAMADA, Keisuke ONO, Kazunari KARAK ...
    2017 Volume 63 Issue 11 Pages 576-581
    Published: November 20, 2017
    Released on J-STAGE: January 22, 2018
    JOURNAL FREE ACCESS

    Syphilis is a sexually transmitted disease caused by a Treponema pallidum infection. We encountered a patient who presented with stomatitis and was given a diagnosis of secondary syphilis. The patient was a 42-year-old woman with chief complaints of difficulty in oral ingestion due to pain in the oral cavity, fever, headache, hair loss, systemic roseola, and keratitis. Serological tests revealed positive results for rapid plasma reagin (RPR) and Treponema pallidum hemagglutination assay (TPHA), forming the basis of our secondary syphilis diagnosis. The bone marrow aspiration test showed positive results for fluorescent treponemal antibody-absorption (FTA-ABS), indicating a neurosyphilis comorbidity. The patient was treated with benzyl penicillin potassium 24 MU/ day for 14 days. Three months after the initiation of treatment, the quantitative value of RPR decreased by 3.7-fold, which indicates cure.

     The recent prevalence of same-sex intercourse and oral sex are causing serious problems because sexually transmitted diseases affect not only sexual organs but also the oropharyngeal tract. The departments that treat sexually transmitted diseases are mainly urology, gynecology, and dermatology. However, there is a concern with regard to an increasing number of cases in which sexually transmitted diseases are diagnosed because of oropharyngeal lesions. Therefore, oral surgeons should also become familiar with the diagnosis and treatment of such diseases.

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  • Yoshiki ISHIDA, Akiko YABASE, Daisuke FUJI, Atsuko HASEGAWA, Takahide ...
    2017 Volume 63 Issue 11 Pages 582-586
    Published: November 20, 2017
    Released on J-STAGE: January 22, 2018
    JOURNAL FREE ACCESS

    Solitary fibrous tumor (SFT), a mesenchymal fibroblastic tumor that was initially seen in the pleura, has recently been reported in extrapleural sites, including the oral cavity. Here we report a case of SFT arising in the tongue and review the literature. A 92-year-old man presented with a history of repeated tongue bites due to a nodular mass on the left side of the tongue. An elastic, movable mass measuring 25 × 20 mm was palpated under the smooth mucosa. Gadolinium-enhanced magnetic resonance imaging showed a homogeneously enhanced mass. Based on the clinical diagnosis of a benign tumor, the lesion was surgically excised with the patient under general anesthesia. Although there was marked swelling of the floor of the mouth on the day after surgery, the patient could eat a normal diet without difficulty 5 days after surgery. Histopathological examination of the tumor revealed spindle cells arranged haphazardly in a variable configuration between collagen strands. Immunohistochemical staining showed that the tumor cells were positive for CD34, bcl-2, and vimentin, leading to a diagnosis of SFT. He was the oldest among the reported Japanese cases of SFT in the oral cavity. There was no sign of recurrence or metastasis 3 years after surgery.

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  • Daisuke SANO, Teruyuki KANAZAWA
    2017 Volume 63 Issue 11 Pages 587-592
    Published: November 20, 2017
    Released on J-STAGE: January 22, 2018
    JOURNAL FREE ACCESS

    Nasoalveolar cyst has been reported to develop in 2.5% of nonodontogenic cysts, with bilateral cysts in about 10% of patients. We report a case of bilateral nasoaiveolar cyst in a 43-year-old Filipino woman. She complained of swelling without tenderness of the right nasal ala. Computed tomography and magnetic resonance imaging revealed bilateral cystic lesions in the nasal vestibule, and there was no relation to teeth. Under a clinical diagnosis of bilateral nasoalveolar cyst, the bilateral lesions were extirpated with the patient under general anesthesia. Both cysts adhered to the floor of the nasal mucosa, and partial resorption of the alveolar bone was noted. Histopathologically, the walls of both cysts consisted of stratified columnar epithelium with many goblet cells. In addition to this case, we analyzed 85 cases reported in the Japanese literature from 1960 through 2015 and discuss the clinical and histopathological features.

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  • Yuki FUJITA, Masahide MIZUTANI, Yuki ARIMURA, Atsushi IKEDA, Yoshinobu ...
    2017 Volume 63 Issue 11 Pages 593-597
    Published: November 20, 2017
    Released on J-STAGE: January 22, 2018
    JOURNAL FREE ACCESS

    This report describes a case of venous malformation associated with multiple phleboliths in the masseter muscle. A 21-year-old woman presented with swelling of the left cheek. Computed tomography and magnetic resonance imaging suggested the presence of phleboliths in the venous malformation in the left masseter muscle. The venous malformation with the phleboliths was extirpated through an intraoral approach with the patient under general anesthesia. The postoperative course was uneventful, and the patient was asymptomatic with no signs of recurrence during 3 years of follow-up.

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