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上颌骨鼠咬状癌酷似右侧磨牙区不愈合拔牙创——1例有趣病例

Carcinoma Cuniculatum of the Maxilla Mimicking Nonhealing Extraction Sockets at the Right Molar Region - An Interesting Case.

作者信息

Ourania Schoinohoriti, Olga Bellou, Vasiliki Karathanasi

机构信息

Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Greece.

Department of General Surgery, KAT General Hospital of Athens, Greece.

出版信息

Eplasty. 2023 Apr 6;23:e23. eCollection 2023.

Abstract

BACKGROUND

Carcinoma cuniculatum is a rare variant of squamous cell carcinoma, mostly affecting the skin but also sparsely reported to occur in the oral cavity. Oral carcinoma cuniculatum (OCC) tends to be misdiagnosed as verrucous carcinoma; this may lead to inadequate treatment and recurrence due to the locally aggressive nature of the tumor. This report presents the case of a 56-year-old man with a progressively enlarging painful OCC at the maxillary right molar region, exhibiting both exophytic (red, soft, nodular mass) and endophytic (superficial ulceration and bone exposure, mimicking nonhealing extraction sockets) growth patterns. Incisional biopsy was consistent with OCC, a diagnosis that was corroborated through histopathologic examination of the resected specimen. The patient underwent resection (segmental maxillectomy) of the tumor and prosthetic rehabilitation with an obturator and remains disease-free 2.5 years postoperatively.

CONCLUSIONS

The aim of this report is to provide a thorough clinical imaging and histopathological presentation of OCC along with a brief literature review to highlight the difficulties of accurate diagnosis and the pitfalls in treating this uncommon entity.

摘要

背景

腺样囊性癌是鳞状细胞癌的一种罕见变体,主要累及皮肤,但也有少量报道发生于口腔。口腔腺样囊性癌(OCC)往往被误诊为疣状癌;由于肿瘤具有局部侵袭性,这可能导致治疗不充分及复发。本报告介绍了一名56岁男性患者的病例,该患者上颌右侧磨牙区出现一个逐渐增大的疼痛性OCC,呈现外生性(红色、柔软、结节状肿物)和内生性(浅表溃疡和骨质暴露,类似拔牙创不愈合)两种生长模式。切开活检结果与OCC相符,切除标本的组织病理学检查证实了这一诊断。患者接受了肿瘤切除(上颌骨部分切除术)及带赝复体的修复重建,术后2.5年无疾病复发。

结论

本报告的目的是提供OCC全面的临床影像学和组织病理学表现,并进行简要的文献综述,以强调准确诊断的困难及治疗这一罕见疾病的陷阱。

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