Sugawara Chieko, Takahashi Akira, Kawano Fumiaki, Kudoh Takaharu, Yamada Akiko, Ishimaru Naozumi, Hara Kanae, Miyamoto Youji
Assistant Professor, Department of Comprehensive Dentistry, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
Associate Professor, Department of Oral Surgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Jan;119(1):e41-8. doi: 10.1016/j.oooo.2014.09.024. Epub 2014 Sep 30.
Neuroendocrine tumors (NETs) arise from neuroendocrine cells and are mostly observed in the gastrointestinal tract, pancreas, and lungs. NETs in the oral and maxillofacial region are extremely rare. We report a case of a 59-year-old woman with an NET in the mandible. The patient did not show any symptoms except for remarkable swelling and bleeding. The lesion appeared as a radiolucent honeycomb abnormality with bone destruction on panoramic radiography. The histopathologic diagnosis following a biopsy was NET. Contrast-enhanced computed tomography (CT), 18F-fluorodeoxyglucose positron emission computed tomography (18F-FDG PET/CT), and adrenal scintigraphy-labeled meta-iodobenylguanidine were the modalities added to identify the primary site. Multiple lesions were confirmed in the gastrointestinal tract. Endoscopy was performed to identify the lesions, and several lesions were observed protruding from the mucous membranes. However, the endoscopy specimens did not yield an accurate diagnosis because adequate samples were not acquired. Blood and urine tests revealed no functional activity caused by the tumors. Although the origin was not histopathologically confirmed with endoscopy, this patient was situationally diagnosed with nonfunctional NET originating from the duodenum, as demonstrated by the metastases in the mandible.
神经内分泌肿瘤（NETs）起源于神经内分泌细胞，多见于胃肠道、胰腺和肺部。口腔颌面部的NETs极为罕见。我们报告一例59岁女性下颌骨NET病例。患者除明显肿胀和出血外无任何症状。全景片显示病变为伴有骨质破坏的透射性蜂窝状异常。活检后的组织病理学诊断为NET。增强计算机断层扫描（CT）、18F-氟脱氧葡萄糖正电子发射计算机断层扫描（18F-FDG PET/CT）和肾上腺闪烁显像标记的间碘苄胍是用于确定原发部位的检查手段。在胃肠道发现了多个病变。进行了内镜检查以识别病变，观察到有几个病变从黏膜突出。然而，由于未获取足够样本，内镜标本未能得出准确诊断。血液和尿液检查未发现肿瘤引起的功能活性。尽管通过内镜检查在组织病理学上未确认起源部位，但鉴于下颌骨出现转移，该患者被临床诊断为起源于十二指肠的无功能性NET。
