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兔穴状癌,一种罕见的口腔鳞状细胞癌变体:5例临床病例报告及文献复习

Carcinoma Cuniculatum, a Rare Variant of Oral Squamous Cell Carcinoma: Presentation of Five Clinical Cases and Review of the Literature.

作者信息

Simón Anna-Maria, de Leyva Patricia, Cárdenas Cristina, Vieira Noemí, García Mónica, Ranz Álvaro, Bueno Ángela, Nuñez Jorge, Almeida Fernando, Picón Manuel, Acero Julio

机构信息

Oral and Maxillofacial Surgery Department, University Hospital Ramon y Cajal, Madrid, Spain.

Pathology Department, University Hospital Ramon y Cajal, Madrid, Spain.

出版信息

J Maxillofac Oral Surg. 2024 Aug;23(4):972-978. doi: 10.1007/s12663-024-02247-9. Epub 2024 Jul 1.

Abstract

BACKGROUND

Oral carcinoma cuniculatum (CC) is a rare variant of squamous cell carcinoma. It exhibits a locally aggressive behaviour, and its histopathology poses a diagnostic challenge, as it can be mistaken for other conditions. We present five cases of oral CC treated at our institution and conduct a comprehensive review of the current literature.

CASE SERIES

Five patients (two women and three men) were treated in our institution with a final diagnosis of oral CC. Ages ranged from 9 to 85 years at the time of diagnosis. Four patients had mandibular involvement requiring mandibulectomy and reconstruction using an osseous free flap. The diagnosis of oral CC was straightforward in the most recent cases. However, for the first two cases, the diagnosis of oral CC was established after thorough discussions between the surgeons and the pathologist regarding the similarities with recent cases. Consequently, the pathological specimens had to be retrospectively re-evaluated to confirm these diagnoses.

CONCLUSIONS

Oral CC is a locally aggressive tumour that can present a challenge for pathologists, often leading to misdiagnosis. According to the existing literature, surgical resection with clear margins is the preferred treatment approach.

摘要

背景

口腔漏斗状癌(CC)是鳞状细胞癌的一种罕见变体。它表现出局部侵袭性,其组织病理学构成诊断挑战,因为它可能被误诊为其他病症。我们介绍了在我们机构治疗的5例口腔CC病例,并对当前文献进行了全面综述。

病例系列

5例患者(2名女性和3名男性)在我们机构接受治疗,最终诊断为口腔CC。诊断时年龄范围为9至85岁。4例患者有下颌骨受累,需要进行下颌骨切除术并使用游离骨瓣进行重建。在最近的病例中,口腔CC的诊断很明确。然而,对于前两例,在外科医生和病理学家就与近期病例的相似性进行深入讨论后,才确立了口腔CC的诊断。因此,必须对病理标本进行回顾性重新评估以确认这些诊断。

结论

口腔CC是一种局部侵袭性肿瘤,可能给病理学家带来挑战,常导致误诊。根据现有文献,切缘清晰的手术切除是首选的治疗方法。

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本文引用的文献

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Oral carcinoma cuniculatum: two cases illustrative of a diagnostic challenge.口腔蕈状癌:两例极具诊断挑战性的病例报告。
Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Oct;116(4):457-63. doi: 10.1016/j.oooo.2013.06.006.
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Oral carcinoma cuniculatum in a young child.一名幼儿的口腔漏斗状癌。
J Clin Pediatr Dent. 2010 Fall;35(1):89-94. doi: 10.17796/jcpd.35.1.9qt8601640386651.

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