Oral and Maxillofacial Surgery Department, Assistance Publique des Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Pierre and Marie Curie University, Paris, France.
Head Neck. 2012 Feb;34(2):291-5. doi: 10.1002/hed.21493. Epub 2010 Jul 27.
Cuniculatum carcinoma is a well-differentiated form of squamous cell carcinoma that shares histologic characteristics with papillary squamous cell carcinoma and verrucous carcinoma. Cuniculatum carcinoma usually occurs on the plantar region, and only 16 cases involving the oral cavity have been described in the literature.
The authors have reported 3 cases of mandibular cuniculatum carcinoma. All of the patients were in a great deal of pain. Histologic diagnosis was difficult due to the presence of few cellular atypies. Clinical criteria, osseous lysis, and the coexistence of multiple intraosseous well-differentiated, hyperkeratotic papillomatous lesions with few cellular atypies sign the diagnosis.
No local recurrence has been reported after treatment with radical surgery alone.
The diagnosis is often delayed. Although cuniculatum carcinoma displays aggressive behavior locally, lymph node infiltration and metastasis are rare. The therapy of choice is surgical removal with free margins, after which the prognosis is excellent.
蚓突状癌是一种分化良好的鳞状细胞癌,具有与乳头状鳞状细胞癌和疣状癌相似的组织学特征。蚓突状癌通常发生于足底,文献中仅描述了 16 例口腔受累病例。
作者报告了 3 例下颌蚓突状癌。所有患者均有严重疼痛。由于细胞异型性较少,组织学诊断困难。临床标准、骨溶解以及多个骨内高分化、角化过度的乳头状瘤病变共存,且细胞异型性较少,提示诊断。
单纯根治性手术治疗后无局部复发。
诊断常被延误。虽然蚓突状癌局部表现为侵袭性行为,但淋巴结浸润和转移少见。治疗方法是广泛切除,切缘无肿瘤,预后良好。