Iwanaga Joe, Iwamoto Osamu, Todoroki Keita, Tanoue Ryuchiro, Koba Akihiro, Kusukawa Jingo
Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan.
BJR Case Rep. 2015 Aug 11;1(3):20150192. doi: 10.1259/bjrcr.20150192. eCollection 2015.
Osteoradionecrosis (ORN) of the jaw is an intractable complication of radiotherapy for head and neck cancer. However, osteolytic lesions are often hard to distinguish from malignancies. We report a rare case of metastatic cancer in a resected mandibular bone after segmental resection for ORN of the jaw. A 63-year-old male with a history of subtotal oesophageal resection for oesophageal cancer and reconstruction of the oesophagus with a gastric tube subsequently developed ORN of the jaw. Conservative treatment was unsuccessful and pathological fracture of the necrotic mandible occurred. The patient underwent segmental resection of the mandible and adenocarcinoma was detected in the resected mandibular bone. Immunohistochemical staining for cytokeratin 7 and 20 revealed that the adenocarcinoma had metastasized from the reconstructed gastric tube. This case highlights the fact that cancers of the gastric tube may metastasize to radiation-induced necrotic bone tissue in the mandible.
颌骨放射性骨坏死（ORN）是头颈部癌放疗的一种难治性并发症。然而，溶骨性病变往往难以与恶性肿瘤区分开来。我们报告1例罕见的颌骨ORN节段切除术后下颌骨切除标本中发现转移癌的病例。一名63岁男性，有因食管癌行食管次全切除并采用胃管重建食管的病史，随后发生颌骨ORN。保守治疗无效，坏死下颌骨发生病理性骨折。患者接受了下颌骨节段切除术，在切除的下颌骨中检测到腺癌。细胞角蛋白7和20的免疫组化染色显示，腺癌是从重建的胃管转移而来。该病例凸显了胃管癌可能转移至下颌骨放射性坏死骨组织这一事实。
