下顎に発生した歯原性癌腫の2例

• Published in: 日本口腔外科学会雑誌 Vol. 56; no. 3; pp. 170 - 174
• Main Authors: 村松, 敬, 武田, 栄三, 柴原, 孝彦, 椎木, さやか, 花上, 健一, 山内, 智博
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 2010
• Subjects: 下顎骨; 歯原性癌腫; 顎骨中心性癌
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.56.170

Most mandibular carcinomas occur in the gingival epithelium. However, some mandibular carcinomas originate from the odontogenic epithelium. Such lesions are called odontogenic carcinomas. Carcinomas primarily occurring in jaw bones are called primary intraosseous squamous cell carcinomas. We report 2 cases of odontogenic carcinoma that occurred primarily in the mandible. Patient 1 was a 69-year-old man without abnormal findings in the oral mucosa. Orthopantomography revealed a radiolucent lesion containing the crown of an impacted tooth. Right hemimandibulectomy, right functional neck dissection, and immediate reconstructive surgery using an A-O plate and a pectoralis major myocutaneous flap were performed. Histopathological examination showed a poorly-differentiated squamous cell carcinoma. Patient 2 was a 56-year-old woman without abnormal findings in the oral mucosa. Orthopantomography revealed a cystic structure containing an impacted tooth in the mandible. Left segmental resection of the mandible, left functional neck dissection, and immediate reconstructive surgery using an A-O plate were performed. Histopathological examination showed a well-differentiated squamous cell carcinoma, and transition of the epithelium of the cyst to squamous cell carcinoma was evident. Although patient 1 died of another disease, the prognosis of patient 2 is good, and niether metastasis nor recurrence has been detected for more than 10 years after surgery.