Necrotizing sialometaplasia is a disease of minor salivary glands that may be confused with, and misdiagnosed as, a malignancy. It was first reported by Abrams and associates in 1973. They described this entity as a lesion of the hard palate that did not recur after surgical excision.
Most of the literatures suggest that an interruption of the blood supply may be the basic cause, but it also has been proposed that necrotizing sialometaplasia may be the ulcerative or terminal stage of leukokeratosis nicotini palati. However there are no previous reports that it is accompanied by any bone defect.
Necrotizing sialometaplasia lesions are large, deeply excavated, and sharply demarcated from surrounding normal mucosa. They are usually located in the vicinity of the junction of the hard and soft palatal mucosa. Because the lesion is usually painless, patients often delay seeking treatment until 3 to 4 weeks after it appears.
The cause of necrotizing sialometaplasia is unknown, but it is conjectured that minor trauma to the mucous membrane may be an initiating factor. Healing usually occurs within 6 to 8 weeks without treatment.

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Desmoplastic ameloblastoma was first described by Eversole in 1984. We recently encountered a case of desmoplastic ameloblastoma in the anterior maxilla.
A 52-year-old man presented to the First Department of Oral and Maxillofacial Surgery of Meikai University. A biopsy was performed, and examination of the biopsy specimen indicated a diagnosis of odontogenic fibroma. The patient underwent tooth extraction in the affected region and tumor resection under general anesthesia.
Microscopic examination after the operation showed an extensive collagenized stroma containing small islets of tumor epithelium with a slight tendency to from cystic structures. The histological diagnosis was thesefore desmoplastic ameloblastoma.

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Arteriovenous hemangioma is apparently caused by some abnormality occurring in the course of development of arteries and veins. It is manifested as an arteriovenous fistula or an arteriovenous aneurysm. Acquired arteriovenous hemangioma is caused by trauma or incomplete excision of a hemangioma. In the oral region, arteriovenous hemangioma usually arises in the jaw bone, and reports of cases arising in soft tissue are rare.
Recently, we treated an arteriovenous hemangioma that had developed in the lower lip and extended to the right buccal region of a 30-year-old woman. Purpura of the mental region had been present since birth. The lesion was excised when the patient was 5 years old, and she subsequently had received surgical therapy four times. Accordingly, angiography showed no characteristic findings of arteriovenous hemangioma, and the lesion was surgically removed. Histologically, the walls of the arteries and veins consisted of well-developed layers of muscle, and the vascular lumen was dilated. Based on these findings, arteriovenous hemangioma was diagnosed.

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Odontogenic fibroma (OF) is a rare benign neoplasm derived from the dental mesenchymal tissues. According to the World Health Organization (WHO), there are two histological types of lesion: the epithelium-poor type (formerly called the simple type) and the epithelium-rich type (formerly called the complex or WHO-type). A 45-year-old man was referred to our department due to swelling of the lower right gingiva. A panoramic radiograph showed a well-demarcated unilocular radiolucent lesion between the 45 and 46 without root resorption. CT showed slight absorption of lingual cortical bone. We underwent biopsy and suspected as fibroma, so we examined tumor excision under general anesthesia. Histopathological diagnosis was odontogenic fibroma. We diagnosed it as epithelium-poor type OF because there were mainly connective tissue lesions and scattered remnants of odontogenic epithelium. The patient has not suffered recurrence after follow-up for 1 year and 4 months.

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The present study was carried out to examine hyaline cells or plasmacytoid cells found in the pleomorphic adenoma of the palate histologically, immunohistochemically, and ultrastructurally. Furthermore, this study presented a review of 13 cases of pleomorphic adenomas with hyaline cells (including our case) in the literature. The round, firm and well-circumscribed tumor, measuring 2×2×2cm, was located in the hard palate of a 28-year old male. Histologically, the tumor consisted mainly of polyhedral or round cells arranged in sheets with the mesenchyma of a fibrous tissue containing hyaline-like component. A relatively large number of hyaline cells with a prominent eccentric nucleus and an eosinophilic cytoplasm were observed among the polyhedral or round cells. The tumor had a small cystic lumen in one area and was almost entirely surrounded with a fibrous capsule. Immunohistochemically, the cytoplasm of the hyaline cell was positive for S-100 protein, vimentin, keratin and GFAP. Ultrastructurally, the cytoplasm was almost filled with intermediate filaments. Clinicopathologically, of 13 previously reported cases of pleomorphic adenomas, 6 were males and 7 females. The ages of the patients ranged from 14 to 46 years with an average of 32.2 years. Of 13 cases, 7 were located in the palatal gland, 5 in the parotid gland and 1 in the submandibular gland.

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白色海綿状母斑は, 1935年 Cannon によって報告された白色病変で, 口腔粘膜も含めてあらゆる粘膜にみられる疾患である。本邦では6報告がみられるにすぎない。遺伝性疾患と考えられている。組織学的に基底細胞層には異常が見られず上皮内の空胞化を伴った上皮の肥厚を特徴とし, 異型性や悪性像もみられない。白色海綿状母斑の本邦における7例目を報告し, 文献的考察を加えた。

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Central odontogenic fibroma (COF) is a rare odontogenic tumor, the primary treatment of which is tumor ablation with extraction of related teeth. We report a case of COF that developed in the left maxilla in a 24-year-old woman. There were no subjective symptoms, however, she had noticed malposition of the second premolar to the palatal side and slight swelling of the buccal gingiva around the tooth since nine years old. The swelling had recently become larger, and she was referred to our clinic. A biopsy of the lesion showed a histological diagnosis of COF. CT images revealed resorption of the alveolar bone around the tumor, and expansion to the roots of the premolars and first molar. Reconstruction of the alveolar ridge using iliac particulate cancellous bone and marrow was carried out immediately after tumor ablation with extraction of the premolars and first molar. Five months later, there was no evidence suggesting tumor recurrence, and alveolar ridge augmentation was clearly apparent on CT images. The serial dental implant treatment was thus completed. The occlusion was restored by an implant prosthesis, and no evidence of tumor recurrence was found during four years of follow-up.

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Carcinomas arising in jaw cysts are a very rare lesion. There was only one case report which was thought to be of origin from an inscisive canal cyst.
The authors present a case of squamous cell carcinoma probably arising from an incisive canal cyst.
The patient was a 60-year-old female with complaints of swelling and tenderness of the hard palate. Overlying mucosa of the lesion was normal except for an opening of fistula.
An occlusal X-ray film and bone images of X-ray computed tomography (X-CT) showed a radiolucent lesion on the midline of the palate with well-defined margin and they also revealed an irregular resorption of the alveolar process of the maxilla.
Soft tissue images of post contrast X-CT showed a heterogenously enhanced area in the anterior part of the lesion extending to the left upper lip.
Pathological examination revealed a squamous cell carcinoma and suggested that the tumor derived probably from an incisive canal cyst.

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慢性硬化性顎骨骨髄炎は難治性の骨髄炎で，症状の急性増悪を繰り返すとされており，SAPHO症候群の部分症状ともされている。開口障害などの症状を呈し，顎関節症との鑑別を要す疾患の1つとされている。今回，われわれは顎関節症との併発が考えられた慢性硬化性下顎骨骨髄炎の1例を経験したので報告する。

患者は20歳女性。右側顎関節部の痛み・開口障害を主訴に当科を受診した。顔貌は左右対称，開口障害と右側顎関節に圧痛・開口時痛を認めた。顎関節症と診断し，アプライアンス療法を2か月間施行し，若干の開口量増加を認めた。同時期，既往のぶどう膜炎に対して抗菌薬およびステロイドを他院にて投与されたところ，顎関節痛が軽度改善した。そのため，感染性の炎症性疾患も疑い，画像検査を行ったが，右側下顎枝の一部に軽度の骨硬化像を認めるのみであった。その後も症状緩解・増悪を繰り返していたが，2年後の画像検査で骨硬化範囲の拡大を認めたため，慢性硬化性下顎骨骨髄炎と診断し，ビスフォスフォネート製剤の投与を開始した。その後，症状は緩解傾向にあり，投薬開始後1年2か月経過するも症状は安定している。

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Verruciform Xanthoma with histopathological characteristics of verruciform growth and the proliferation of xanthoma cell in the lamina propria was first described in 1971 by Shafer as Histiocytosis-Y. Though occasionally reported later in occidental countries, this disease is relatively rare. Especially in Japan this disease is rarely documented. The gingiva is a common site of occurrence. Those occurring in the tongue or buccal mucosa are very rare. Recently we encountered a 64-year-old woman with this disease in the left lateral margin of the tongue.

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Necrotizing sialometaplasia is an inflammatory self-healing lesion emanating from the salivary gland. This lesion is easily confused with squamous cell carcinoma or mucoepidermoid carcinoma because clinical and histological appearances are similar. A twenty-threeyear-old female was referred to us complaining of swollen palate. The lesion was suspected to be salivary gland tumor. Histological examination revealed necrotizing sialometaplasia emanating from a minor salivary gland of the palate. Her lesion almost completely healed without treatment after 4 weeks.

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We report a case of polymorphous low-grade adenocarcinoma (PLGA) involving the hard palate of a 71-year-old woman.Physical examination revealed a 19×17mm painless swelling of the palate without mucosal ulceration. The cervical lymphnodes were not palpabe. Clinical diagnosis of minor salivary gland tumor was made, and an excisional biopsy was performed. She recovered uneventfully, and no additional therapy was administered. She has remained disease-free for 30 months after the operation.
The excised specimen consisted of a circumscribed but unencapsulated, grey/white-to-tan mass with an intact overlying mucosa. Microscopically, the tumor contained a variety of growth patterns: solid, trabecular, cribriform, papillary, and monolayered tubular structures. The tumor cells were uniform with bland oval nuclei, and mitotic figures were not seen.The resection margins were not involved. Immunohistochemically, most of the tumor cells showed positive staining for vimentin, S-100 protein, and sometimes for muscle-specific actin, as well as for cytokeratin, indicative of their neoplastic myoepithelial natures. It is interesting that some of these were also positive for epithelial membrane antigen. On the other hand, the tumor cells were entirely negative for glial fibrillary acidic protein. These immunoprofiles may be useful in distinguishing PLGA from other salivary gland tumors bearing histologic resemblances.

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顎下腺に発生したoncocytic lipoadenomaの1例を報告する.
症例は66歳女性. 右顎下腺腫瘍にて紹介受診となった. 46×40mmの非常に軟らかい腫瘤であり可動性は良好であった. 手術施行し病理組織検査にてoncocytic lipoadenomaと診断した. 術後経過は良好で再発も認めていない. Oncocytic lipoadenomaは, 成熟した脂肪細胞とoncocyte化した唾液腺組織が混在する極めて稀な唾液腺良性腫瘍のことをいい, 1998年にHirokawaらが初めてその概念を提唱した. 我々が渉猟しえた限りでは, その報告例はこれまで国内・国外にて6例を認めるのみであった.

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