日本口腔科学会雑誌
Online ISSN : 2185-0461
Print ISSN : 0029-0297
ISSN-L : 0029-0297
最新号
選択された号の論文の9件中1~9を表示しています
特別企画記事
症例報告
  • 伊藤 耕, 枝 卓志, 山﨑 文惠, 高橋 康輔, 青木 暁宣, 近藤 壽郎
    2019 年 68 巻 4 号 p. 273-278
    発行日: 2019年
    公開日: 2019/12/27
    ジャーナル 認証あり
    Giant cell granuloma (GCG) is widely considered as being non-neoplastic. Recently, non-surgical mandibular approaches such as intralesional corticosteroid have yielded favorable outcomes. Here we describe a patient with a GCG that worsened under intralesional corticosteroid injection, and review the literature.
    A 60-year-old female patient was referred to us with a large painful mass in the left mandible. Panoramic radiography and computed tomography (CT) revealed a 3×4-cm multilocular radiolucent area within the mandible that was pathologically diagnosed as a GCG from a biopsy. The patient was treated thirteen times with intralesional injections of triamcinolone acetonide (Kenacort-A 20mg) once per week aiming to reduce and eliminate the lesion. Nevertheless, the GCG increased to 4×6cm, so the tumor was surgically resected under general anesthesia. The patient has remained free of relapse for 33 months and has a good prognosis.
    Almost all reports describe that local steroid injections reduce or eliminate mandibular GCG, and a tendency to increase in size is rare. It is suggested that surgery should be done promptly when GCG does not respond to local steroid injection.
  • 伏見 一章, 椎葉 正史, 中嶋 大, 神津 由直, 坂本 洋右, 丹沢 秀樹
    2019 年 68 巻 4 号 p. 279-282
    発行日: 2019年
    公開日: 2019/12/27
    ジャーナル 認証あり
    Hemangioma is often found in the head and neck region, but it occasionally occurs in salivary glands, especially in the submandibular gland. A 40-year-old male was referred to our division with a painless swelling in the left submandible. A hen's egg-sized mass with an elastic, soft and flexible feeling was observed in the left submandibular region. Abnormal change in the oral cavity was not found. The clinical diagnosis was a suspected salivary gland tumor. The tumor was surgically removed under general anesthesia. The dark red tumor was partially adhered to the submandibular gland, however, the border between the lesion and the surrounding tissues was clear. The mass, which consisted of the tumor and submandibular gland, was easily removed in a group. Since malignancy was not ruled out due to its rapid growth, an instant pathologic examination was performed during the surgery. Since no signs of malignancy were found in the examination, additional procedures such as extensive excision were not necessary during surgery. The final pathological examination revealed that the lesion was mainly composed of arteries, veins and capillaries of various sizes, and there was no malignant change in the lesion. Thus, considering the clinical and pathological findings, the tumor was diagnosed as a cavernous hemangioma in the submandibular gland. Two years have passed since the surgery, and both his general and local conditions are good with no sign of recurrence of symptoms.
  • 金子 真也, 山縣 憲司, 菅野 直美, 内田 文彦, 柳川 徹, 武川 寛樹
    2019 年 68 巻 4 号 p. 283-286
    発行日: 2019年
    公開日: 2019/12/27
    ジャーナル 認証あり
    Stickler syndrome is an autosomal-dominant disorder caused by mutation of pro-collagen genes and characterized by bone malformation, eye disease, mandibular micrognathia, and cleft palate in the oral and maxillofacial region. Palatoplasty is associated with the risk of difficulty of intubation because of the small jaw and airway obstruction caused by postoperative edema during the peri-surgical period.
    Here, we describe the case of a 4-month-old girl with Stickler syndrome with a past history of being intubated and sedated because of an airway obstruction caused by glossoptosis and laryngomalacia who was intubated and sedated after palatoplasty. To prevent complications, in consensus with pediatricians and anesthesiologists, the patient was managed postoperatively with intubation and sedation in the pediatric intensive care unit. Evaluation of the level of swelling and extubation was performed in 2 days. She was discharged from the hospital with no complications 7 days post-surgery as is done in usual cases of palatoplasty. We consider that the combined use of intubation and sedation is effective in preventing peri-operative complications after palatoplasty in a patient with Stickler syndrome.
  • 矢田 光絵, 山田 龍平, 大竹 一平, 石原 修
    2019 年 68 巻 4 号 p. 287-293
    発行日: 2019年
    公開日: 2019/12/27
    ジャーナル 認証あり
    Syphilis is a common sexually transmitted disease which is caused by Treponema Pallidum. Although its incidence has dramatically decreased with the use of penicillin since World War Ⅱ, a significant resurgence of syphilis has been reported in Japan. It is rare to encounter late syphilis due to the spread of antimicrobial agents. We report a case of tertiary oral syphilis in the upper jaw with anti-resorptive agents-related osteonecrosis of the jaw (ARONJ). An 82-year-old woman presented in our hospital because of gingival pain. She was treated with alendronic acid sodium hydrate and denosumab for osteoporosis. Based on a biopsy of the left maxillary palate and blood test, syphilis gumma was diagnosed. The symptoms of syphilis infection were not seen until 82 years old, and there was no history of clear lesions equivalent to syphilis stage Ⅰ, or Ⅱ. In this case, we performed the sequester exclusion method after treating the syphilis with Amoxicillin (AMPC) medication. No evidence of disease recurrence has occurred 25 months after treatment.
  • 信本 忠義, 神田 拓, 林 靖也, 谷 亮治, 小川 郁子, 岡本 哲治
    2019 年 68 巻 4 号 p. 294-298
    発行日: 2019年
    公開日: 2019/12/27
    ジャーナル 認証あり
    Eosinophilic granulomatosis with polyangiitis (EGPA) is classified as anti-neutrophil cytoplasmic antibody associated vasculitis, which is a necrotizing vasculitis with mainly lesions in small blood vessels such as capillaries and venules. It is a rare systemic vasculitis disease. The number of people affected in Japan is currently around 2000, and it is estimated that there are 100 new patients each year.
    The disease had been conventionally called Churg-Strauss syndrome or allergic granulomatous vasculitis, but in 2012 it was renamed EGPA. In the head and neck region, bilaterally symmetrical salivary gland swelling has been shown. Treatment is mainly based on steroid therapy and has a good prognosis, but occasionally there are reports of severe complications such as intestinal perforation and heart failure.
    We report a case of EGPA showing IgG4-related disease. The symptoms such as salivary gland swelling disappeared with steroid therapy after we consulted the department of rheumatology and connective tissue disease, but four months after the initial treatment, systemic symptoms such as fatigue, facial edema, skin redness in the upper and lower limbs and re-elevation of peripheral blood IgE, IgG4 and eosinophil were observed. Accordingly, we consulted the department again and diagnosed EGPA.
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