摘要
化膿性肉芽腫之病理致病機轉可能與血管增生因子和激素刺激有關，組織學上最重要的特點爲腫瘤內的葉狀微血管增生，5%之孕婦會有口腔化膿性肉芽腫，稱之爲妊娠性肉芽腫。一名39歲孕婦，從下嘴唇潰瘍處逐漸長出一顆腫瘤，病灶在4週內長到2.0×1.0×0.5cm，嚴重影響外觀與進食，遂建議手術切除。術後組織病理呈現多叢聚集成簇的微血管，確定爲化膿性肉芽腫；根據臨床特點與組織病理，診斷爲妊娠性肉芽腫。妊娠性肉芽腫的處置需權衡症狀的嚴重程度與妊娠的狀態，原則以保守觀察爲優先，直到生產過後再做定奪。除非當下長得太大影響外觀或生活，才需考慮手術切除。需注意的是，切除後易復發。
並列摘要
The patho-physiology of pyogenic granuloma (PG) may be related to angiogenic factors or the influence of hormones. Specifically, the disease involves lobular capillary proliferation inside the lesion. About 5% of pregnant women suffer from oral PG or so called granuloma gravidarum (GG). A 39-year-old pregnant woman presented with a tumor that had developed from an ulcer on her lower lip. The lesion had grown into a 2.0×1.0×0.5 cm lump over four weeks. The lesion had a deleterious effect on the patient's facial appearance and caused eating difficulties; therefore, surgical excision was scheduled. A post-operative pathological study revealed capillary proliferation aggregated into multiple lobules, which confirmed PG. Therefore, based on the clinical characteristic and pathology, GG was diagnosed. Conservative treatment is normally preferred for GG until parturition. This is because there is a high likelihood postoperative recurrence and, based on this, excision is not immediately recommended except when the lesion is large in size.
延伸閱讀
- 郭英雄、郭生興、江俊斌、王拯宗、劉步遠、吳鴻宜（1994）。上唇之多形性腺瘤。中華民國口腔顎面外科學會雜誌，5(2)，42-48。https://doi.org/10.7104/CJOMS.199409.0042
- Chun, J. K., Bluestein, H. J., Behnam, A. B., Dottino, P., & Silver, L. (1998). 橫向內陰皮瓣作為陰部陰唇之重建. 中華民國重建整形外科醫學會雜誌, 7(1), 1-7. https://doi.org/10.7096/JPRSA.199803.0003
- 林從慶、高志平（1989）。陰囊胚胎細胞型橫紋肌肉瘤。當代醫學，(188)，530-532。https://doi.org/10.29941/MT.198906.0023
- 陳怡伶、吳爭融、王峙仁（2021）。局部皮瓣與游離皮瓣在下唇重建之應用－二病例報告。臺灣口腔顎面外科學會雜誌，32(4)，281-288。https://www.airitilibrary.com/Article/Detail?DocID=a0000494-202112-202111190007-202111190007-281-288
- Chang, W. H., Lien, H. C., & Chen, Y. S. (2005). Schwannoma of the Nasal Tip. 台灣耳鼻喉頭頸外科雜誌, 40(4), 158-163. https://doi.org/10.6286/2005.40.4.158