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下颌骨硬化性牙源性癌 1 例并文献复习。

A case of sclerosing odontogenic carcinoma of the mandible with a review of the literature.

机构信息

Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.

Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.

出版信息

J Oral Sci. 2023;65(4):281-283. doi: 10.2334/josnusd.23-0187.

Abstract

Sclerosing odontogenic carcinoma (SOC) is a very rare malignant odontogenic tumor characterized by sclerotic stroma and single-file cord-like tumor cell structures. A 38-year-old man presented with extraoral swelling and right mental region paralysis. Panoramic radiography revealed an ill-defined radiolucent lesion extending from the right mandibular ramus to the right lower canine. Magnetic resonance imaging showed tumor invasion into the right inferior alveolar nerve and masseter muscle. Hemimandibulectomy, bilateral neck dissection, and mandibular reconstruction were performed using a rectus abdominis musculocutaneous flap and a titanium plate. Histopathology and immunohistochemistry confirmed SOC diagnosis. No recurrence occurred in the 1-year follow-up. In this paper, a case of SOC with a high Ki-67 labeling index was reported. Since SOC is prone to nerve invasion, treatment is resection with an appropriate surgical margin.

摘要

硬化性牙源性癌(SOC)是一种非常罕见的恶性牙源性肿瘤,其特征为硬化性基质和单行条索状肿瘤细胞结构。一名 38 岁男性因面部肿胀和右侧颏部麻痹就诊。全景片显示从右侧下颌支到右侧下颌尖牙有一个界限不清的透光性病变。磁共振成像显示肿瘤侵犯右侧下牙槽神经和咬肌。采用腹直肌肌皮瓣和钛板进行了半下颌切除术、双侧颈清扫术和下颌骨重建。组织病理学和免疫组织化学证实了 SOC 的诊断。在 1 年的随访中没有复发。本文报道了一例 Ki-67 标记指数较高的 SOC 病例。由于 SOC 易发生神经侵犯,治疗方法是在适当的手术切缘下进行切除。

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