Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 64, Issue 11
Displaying 1-6 of 6 articles from this issue
Preface
Original article
  • Tomoyuki TANO, Hidenori UNE, Nozomu FUKUI, Yoichiro NAKAJIMA, Yoshihir ...
    2018 Volume 64 Issue 11 Pages 634-639
    Published: November 20, 2018
    Released on J-STAGE: January 21, 2019
    JOURNAL FREE ACCESS

    Cetuximab is a molecular targeting drug used to treat various malignant tumors. Although patients with head and neck cancer treated with cetuximab had longer survival, notable adverse effects were frequently observed as compared with patients who received chemotherapy with cytotoxic drugs. In this study, we investigated cetuximab-induced hypomagnesemia in patients with oral cancer. From February 2013 through May 2017, 33 patients who received cetuximab in combination with chemotherapy or radiotherapy were studied. Among the patients, 17 (51.5%) presented with symptoms of hypomagnesemia and 3 (9.1%) had Grade 3/4 hypomagnesemia. In the subgroup of patients who received cetuximab combined with radiotherapy (25 patients), 12 (48%) had hypomagnesemia and 1 (4%) had Grade 3/4 hypomagnesemia. In another subgroup of patients who received cetuximab combined with chemotherapy (8 patients), 5 (62.5%) had hypomagnesemia, and 2 (25%) had Grade 3/4 hypomagnesemia. Magnesium sulfate was intravenously administered to patients with Grade 2 reactions. Cetuximab therapy was discontinued, and magnesium sulfate was continuously given to patients with Grade 4 hypomagnesemia. The results suggested that a history of treatment with cisplatin, repeated administration of cetuximab (≥7 courses), and acneiform rash (≥Grade 2) were significant risk factors for hypomagnesemia. In conclusion, regular monitoring of serum magnesium levels and early supplementation with a magnesium preparation are considered crucial in patients treated with cetuximab.

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Case reports
  • Airi FUKUOKA, Kazutoshi NAKAOKA, Hayaki NAKATANI, Hiroaki SHIGEMATSU, ...
    2018 Volume 64 Issue 11 Pages 640-644
    Published: November 20, 2018
    Released on J-STAGE: January 21, 2019
    JOURNAL FREE ACCESS

    We report a case of multiple ossifying fibromas arising in the mandibular ramus, including the condylar process. A 19-year-old woman was referred to our clinic by her dentist because radiolucent lesions were detected in the right side of the mandible on a panoramic radiograph. Although she had no symptoms, CT images revealed multiple lesions in the right mandibular angle (lower lesion) and condylar process (upper lesion). At first, complete removal of the lower lesion and partial removal of the upper lesion were performed with the use of a surgical template for pathological diagnosis. The specimens were definitely diagnosed as ossifying fibroma. Secondarily, we completely resected the upper lesion by open temporomandibular joint surgery. The bone defect of the condyle after tumor removal was immediately reconstructed with particulate cancellous bone and marrow harvested from the iliac crest. There was no evidence of recurrence or jaw dysfunction at the 3-year follow-up after surgery.

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  • Mirei TAKAI, Naofumi AOKI, Michinori MAEDA, Marina HIROSE, Toshio SHIG ...
    2018 Volume 64 Issue 11 Pages 645-649
    Published: November 20, 2018
    Released on J-STAGE: January 21, 2019
    JOURNAL FREE ACCESS

    Adenosquamous carcinoma (ASC) is defined as a tumor showing components of adenocarcinoma with well-formed ductal structures and squamous cell carcinoma (SCC) in the same lesion. Only a few cases of oral ASC have been reported. The prognosis of ASC is generally poor. On the other hand, it has been demonstrated that the malignant transformation of oral leukoplakia is generally associated with pathological findings of well-differentiated SCC with low-grade malignancy. In this paper, we report a case of ASC on the tongue that developed during follow-up for leukoplakia. A 66-year-old woman visited our hospital with a chief complaint of a white painful tongue lesion in November 2009. At presentation, a white rough surface lesion measuring 18 × 8 mm was noted on the right margin of the tongue. The lesion was diagnosed to be oral leukoplakia on initial biopsy. After 3 years 10 months of observation, an erosive lesion was found at the same region. The lesion was diagnosed to be SCC on a second biopsy, and partial glossectomy was therefore performed. The surgical specimen revealed that growth and invasion of nuclear chromatin-rich atypical cells including Alcian-blue-positive mucous cells and partially recognized ductal structures. Finally, the lesion was diagnosed to be ASC (pT1N0M0). As of 4 years and 2 months postoperatively, the patient is doing well, with no evidence of recurrence.

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  • Tsuyoshi SHIMOSATO, Yasuyuki ASADA, Takeshi ADACHI, Yuka WATANABE, Yos ...
    2018 Volume 64 Issue 11 Pages 650-654
    Published: November 20, 2018
    Released on J-STAGE: January 21, 2019
    JOURNAL FREE ACCESS

    Giant cell arteritis (GCA) is a disease entity characterized by histopathological findings of granuloma formation with giant cells in arterial walls. It causes dysfunction of several important organs secondary to stenosis or obstruction of the affected vasculature. We treated a 76 -year old woman who presented with trismus and facial pain during jaw movements. She additionally had marked fatigue and masticatory muscle pain, and her maximum jaw range of motion was 30 mm. Both superficial arteries were swollen. She also complained of visual impairment in that the lower part of her right visual field would darken for several seconds. After a biopsy of the superficial artery, she was given a histopathological diagnosis of GCA. She fulfilled the GCA diagnostic criteria established by the Ministry of Health of Japan, a specific disease research group, and the American Association of Rheumatology. Pulse steroid therapy was administered in the Department of Neurology, and her symptoms markedly improved. She has shown good progress since then.

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  • Yusuke MATSUZAKI, Yukio WATABE, Junko NIWA, Daisuke KOBAYASHI, Isao KA ...
    2018 Volume 64 Issue 11 Pages 655-660
    Published: November 20, 2018
    Released on J-STAGE: January 21, 2019
    JOURNAL FREE ACCESS

    We report a case of basal cell adenocarcinoma of the upper lip in which reconstruction was performed using a V-Y advancement flap. The patient was a 59-year-old man who presented with a left upper lip mass that was 15 mm in diameter, elastic hard, and mobile. The patient reported no pain on palpation, and no metastasis was evident in regional lymph nodes. The tumor was homogeneous inside the left upper lip on CT soft-tissue display, appearing somewhat hyperdense as compared with muscle. Based on the results of biopsy, adenocarcinoma was diagnosed. With the patient under general anesthesia, the left upper labial mucosa was dissected, and the tumor was excised en bloc with the overlying skin. We performed a reconstruction procedure combining a rhomboid flap and a V-Y advancement flap. The pathological diagnosis was basal cell adenocarcinoma. No local recurrence or metastasis has been seen as of 2 years postoperatively.

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