1 歳 6 カ月男児の左上顎骨に発生したを経験した。粘液腫は良性の疾患であるが，病変の完全切除のために時には拡大切除を要する。今回は顎顔面の成長と術後の整容および機能を考慮して，上顎骨および上顎洞粘膜，眼窩下神経を温存した摘出・掻破術を行い順調な経過をたどった。本疾患において手術治療を行った国内最年少例として報告する。

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Odontogenic myxofibroma is a rare and locally invasive benign neoplasm, which is a variant of odontogenic myxomas. Odontogenic myxofibromas contain considerable amounts of collagen fibers, dispersed within a myxoid stroma. The radiographic features of odontogenic myxofibromas are variable, and so it is difficult to diagnose this condition. We present a case of odontogenic myxofibroma in the right maxilla of an 18-year-old woman.
An operation was performed to carry out tumor extraction and curettage; during this procedure, a residual tumor in the pterygopalatine fossa region was noted. This residual tumor was removed during a second surgery via a Le Fort type I osteotomy. The patient has reported no tumor recurrence during the 5 years post-operation.

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は歯原性腫瘍の中において比較的稀な腫瘍である。今回我々は上顎に発生したの1症例を経験したので報告する。症例は15歳の男性。主訴は右鼻閉と右頬部腫脹であり, 近医耳鼻咽喉科を受診したところ右上顎腫瘍を疑われ当院紹介受診となった。CT, MRIでは右上顎洞を中心に約6cmの分葉状輪郭を呈する腫瘤と埋没歯牙を認め, 歯原性腫瘍を疑った。腫瘍の発育状況よりその全摘出は困難であると考え, 診断を含めてナビゲーション併用下での内視鏡下鼻内手術にて腫瘍減量術を行った。術後病理検査でと診断された。若年発症であり今後外来で十分な経過観察が必要と思われる。

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Odontogenic myxoma is a relatively rare lesion in the oral and maxillofacial region, and it is a locally invasive tumor. We report a case of odontogenic myxoma that extended into the maxillary sinus in a child who was successfully treated by extirpation and curettage. A 12-year-old girl complained of a swelling in the left cheek region. An elastic-hard swelling measuring approximately 40 × 50 mm was found in the left maxillary region. The clinical diagnosis was an odontogenic myxoma of the left maxillary region. Radiographic and computed tomographic examinations showed an aggressive tumor widely extending into the maxillary sinus and left palatal region, with partial radiopacity in the central region. A pathological diagnosis of odontogenic myxoma was made on a biopsy examination. We extirpated the lesion and performed curettage with the patient under general anesthesia. The patient has had no sign of recurrence for 53 months.

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は顎骨に発生する比較的まれな良性腫瘍である。顔面の変形や複視をきたすため手術が第一選択とされるが，周囲組織を含めて切除するか腫瘍摘出と掻爬に止めるかは意見が分かれる。症例は40代女性，右頰部違和感，鼻閉を主訴に来院，CT，MRI検査で右上顎洞内に44mm大の腫瘍を認めた。局所麻酔下に経下鼻道で上顎洞内から生検し，と診断された。治療は，endoscopic modified medial maxillectomyでの腫瘍の切除および抜歯を行い，掻爬を行った。一期的に手術と抜歯を行ったことで，抜歯窩と鼻腔双方からのアプローチが可能となり，良好な視野で掻爬することができた。

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A case of odontogenic myxofibroma occuring from anterior teeth to premolar area of the mandible is reported.
A-24-year old female was referred to our clinic because of a gingival swelling in the right mandibular region in May 1997. A radiograph showed a multiocular radiolucent lesion described as a “soap bubble”. Surgical excision and curettage of the lesion were performed under general anesthesia. Histopathological examination revealed myxomatous tissue with epithelial islands suspected to be odontogenic, and the diagnosis was odontogenic myxofibroma.
Recurrence was not found a year after surgery.

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A patient with a large odontogenic myxoma of the maxilla is described. A 13-year-old boy was referred to our hospital because of a swelling in the maxilla. Radiographic and computed tomographic examinations showed a well-demarcated tumor in the maxillary sinus that contained small calculi and was associated with extensive resorption of maxillary bone. Histological examination revealed that the tumor consisted of spindle-shaped cells with no atypia in the myxomatous connective tissue. Scattered cement-like small calculi were present. An odontogenic myxoma was diagnosed. The tumor was extirpated by an intraoral approach. There has been no evidence of recurrence 18 months after surgery.

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Odontogenic myxoma is a relatively rare benign tumor that accounts for 3%–5% of odontogenic tumors. Although benign, tumor enucleation or the scratch technique can easily result in local recurrence, and resection that includes a tumor-free circumferential margin is recommended.

Whereas with the grow maxillofacial in young people is related, and an extended operation is difficult, and only tumorectomy, scratch technique may be performed in the fact. Here, we report the use of a transcanine fossa approach and nasal endoscopic surgery to perform a segmental resection of the maxilla so as to remove an odontogenic myxoma. Previous literature on this topic is also discussed.

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　症例は60歳男性。5年ほど前から間欠的な嗄声を自覚していた。1年前から嗄声の増悪を認めたため当科を紹介受診した。左声帯に広基性の腫瘤を認め，全身麻酔下に直達喉頭鏡を用いて摘出した。術後病理診断は粘液腫であった。粘液腫は軟部組織を起源とする良性腫瘍である。喉頭に発生する粘液腫は非常に稀であり，現在までに発表された症例は20例に満たない。良性腫瘍であるが，発生場所によっては高率な再発率が指摘されている。手術の際には取り残しのないよう注意が必要であるとともに術後2～3年程度の経過観察が必要な疾患である。

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An odontogenic myxoma is reported. A 21-year-old man complained of painless swelling at the left lower molar region. Radiographs of the lesion showed a intra-bony mutilobular radiolucency. Examination of a biopsy specimen suggested an odontogenic myxoma. The lesion was managed by mandibulectomy under general anesthesia, immediately followed by iliac autograft and sural nerve transplantation. Histological examination revealed loosely arranged, spindle-shaped and stellate cells with fine collagen fibers. Odontogenic epithelial cell nests were found among the myxomatous cells. From these findings, the lesion was diagnosed as an odontogenic myxoma. The patient was observed a year later and no evidence of recurrence was detected.

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Myxoma is relatively rare in the stomatognathic region. The patient was a 16-year-old boy with an odontogenic myxoma occupying almost the entire right maxillary sinus. A panoramic radiograph showed clinically significant alveolar bone resorption in the right maxilla and a divergence between the right upper lateral incisor and canine. A computed tomographic scan revealed a neoplastic lesion extending throughout the right maxillary sinus. The lesion had caused thinning of the anterior, posterior, and inner walls of the maxillary sinus. The tumorlike mass was diagnosed as an odontogenic myxoma on biopsy and was surgically excised with the patient under general anesthesia. Follow-up 14 months after tumor resection indicated a good prognosis with no signs of recurrence to date.

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Odontogenic myxoma is a relatively rare benign tumor with local invasion. We report a case of odontogenic myxoma arising in the maxilla of a child.
An 8-year-old girl was referred to us to receive treatment for a right maxillary tumor. Diffuse elastic hard swelling was present in the right cheek, right upper molar, and hard palate region. Radiographic and computed tomographic examinations revealed a 48 × 41 × 34 mm mass obliterating the right maxillary sinus, with destruction of the sinus walls. The patient underwent partial maxillectomy followed by cryosurgery under general anesthesia. Histopathological examination showed that the tumor consisted of stellate-or spindleshaped cells in a myxoid matrix. The matrix was positive for Alcian blue stain, and the tumor cells were positive for vimentin and S100 protein. The histopathological diagnosis was odontogenic myxoma. No clinical or radiological recurrence was noted during a follow-up period of 4 years.

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Odontogenic myxoma is a comparatively rare lesion of the jaw bone. A case of odontogenic myxomaoccurring in the mandible of a young girl that was treated by two-stage surgery to preserve the form of themandible is presented. A 12-year-old girl was referred to our hospital because of a painless swelling in the rightlower molar region. Radiographic examinations revealed multilocular radiolucency with a fine“soap bubble”appearance, accompanied by impacted second and third molars, at presentation.
As much as possible of the tumor was removed by an intraoral approach with the patient under general anesthesia. To conserve jaw and mouth function, segmental resection was not performed. Histological examination revealed a tumor consisting of proliferative spindle cells without nuclear atypia in an abundant myxoid stroma. Islands of odontogenic epithelium were found within the tumor. A pathologic diagnosis of odontogenic myxoma was made. Three years later, secondary surgical removal of the tumor was carried out after the bone had regenerated. At present, 3 years after secondary surgery, bone has formed in the cavity remaining after the operation, and the tumor has not recurred. The patient will be carefully observed for tumor recurrence hereafter.

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A case of odontogenic myxoma of the mandible is reported. A 52-year-old woman was referred with painless swelling in the anterior portion of the mandible. The swelling had been present for 15 years and enlarged gradually. On examination, there was firm swelling in the anterior tooth region and both labial and lingual expansion of the lower alveolus were noted. X-ray films showed a well-defined intra-bony multilobular radiolucency. The biopsy suggested odontogenic myxoma. Under endotracheal anesthesia, partial resection of the mandibule was performed by an intra-oral approach. The tumor was a solid yellow white mass and showed myxomatous appearance. The bone defect was immediately reconstructed with HAP particules (Actceram K^®), HAP-TCP block and autogenous iliac cancelous bone. In histological examination the specimen showed loosely arranged, spindlesaped and stellate cells with fine collagen fibers. There were odontogenic epitherial cell nests and a small number of calcified materials like cementicle. From these findings, the lesion was diagnosed as odontogenic myxoma. The patient was observed two years later and there was no evidence of recurrence.

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We present a case of a 62-year-old woman with myxoma of the zygoma. There was no clinical sign except abnormal feeling of left buccal region. Computed tomography showed a well-defined low density lesion in the left zygoma with a deficit of cortical bone. The tumor measuring 1.3×1.0×1.0cm was surgically removed under general anesthesia, and was translucent white with a smooth surface and soft consistency.
Histopathological findings showed myxoma with no signs of malignancy. As myxoma rarely has a capsule and invades the adjacent bone, the bone surface was sufficiently shaved using a surgical burr. There has been no evidence of recurrence for 19 months postoperatively.

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Peripheral odontogenic myxoma of the oral cavity is extremely rare. We present a case of peripheral myxoma arising from the mandibular anterior lingual gingiva in a 55-year-old man. Intraoral examination revealed a solitary, elastic-hard mass on the lingual gingiva of the mandibular in the range of right first incisor to canine, measuring 13mm in diameter. The mucosa of the mass was partially white in color, and the shape of the mass was slightly irregular. Abnormal uptake FDG on PET/CT (SUVmax 9.9) was observed in the anterior mandible. The mass was excised with a margin of healthy gingiva. The histopathologic diagnosis was peripheral odontogenic myxoma. Follow-up for 2 years after excision has shown no evidence of recurrence.

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瘍は 2017 年の WHO 分類で、豊富な粘液基質の中に星状もしくは紡錐形細胞を含む良性間質性腫瘍と定義されている。歯原性腫瘍の中では 1.6 − 2.7％とまれな疾患である。粘液腫は膠原線維を含む割合によって粘液線維腫と呼ばれる。今回われわれは、右上顎より発生した歯原性粘液線維腫を経験したので報告する。患者は 31 歳、男性、 3 カ月前より右鼻閉を自覚していた。初診時、右鼻腔を充満する腫瘤および無痛性の上顎歯肉、硬口蓋、口腔の腫脹を認めた。顔面 CT では腫瘍は上顎骨の破壊を伴い、上顎洞、鼻腔、硬口蓋、篩骨洞、蝶形骨洞、側頭下窩、上咽頭まで進展していた。歯肉部からの生検の結果、粘液腫と診断された。手術は Weber-Ferguson の皮切を用いて、右上顎亜全摘術を行った。病理診断にて紡錐形の間葉系細胞に異型はなく、膠原線維を多く含むことから粘液線維腫と診断された。

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We report a case of odontogenic myxoma in the mandible associated with schizophrenia. A 39-year-old female consulted us because of trauma to the orofacial region caused by drug-induced parkinsonism, and a myxoma was discovered incidentally on a radiographic examination. Radiographs of the lesion showed a monolocular radiolucency in the mandible. It was necessary for the myxoma to be removed, but the patient had to wait for surgery because of unstable symptoms of schizophrenia. After 3 months, the psychiatric symptoms gradually decreased, and social skills were rehabilitated. A tissue biopsy confirmed the diagnosis of myxoma. In March 2005, we performed a segmental mandibulectomy, and the mandible was reconstructed with an iliac bone graft and internal-maxillary fixation（ IMF） with elastics. Given our effort to build rapport with the patient preoperatively, there were few complaints about the IMF and pain during the perioperative period. In this patient, no recurrence has been observed as of 3 years 7 months after operation.

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Oral focal mucinosis (OFM) is a rare disease that forms a mass with the production of mucoid substances under the oral mucosa. The details of OFM etiology and pathophysiology are not clear. We report a case that was histopathologically diagnosed as OFM; however, nine years had passed between the diagnosis and the time of the first treatment. The patient was a 64-year-old male found to have a 13 × 9 mm mass in the left palate. Biopsy revealed growth of collagen fibers and mucoid substances containing hyaluronic acid below the epithelium, and OFM was initially diagnosed. His next planned visit to the hospital was interrupted, and nine years following his initial visit, he requested the treatment and was re-examined. The mass had increased to 17 × 12 mm toward the hard palate and was resected under general anesthesia. The mass was surrounded by fibrous tissue and was easily detached from the surrounding tissue, with no exposed bone observed. There was no histopathological change in the tissue structure. No recurrence after resection has been observed.

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