- 期刊
Metastasizing Ameloblastoma (Malignant Ameloblastoma)-An Unusual Cause of Multiple Lung Nodules
轉移性造釉細胞瘤（Metastasizing Ameloblastoma）－多處肺結節之罕見原因
摘要
造釉細胞瘤是一種不常見的良性、局部侵襲性的齒源性腫瘤。其約佔所有顎腫瘤及顎囊腫的百分之一。儘管很容易局部復發，造釉細胞瘤甚少遠端轉移。在遠端轉移之少數個案中肺為最常見轉移的位置。我們提出討論的個案為一位下頷患患結締組織增強性造釉細胞瘤（desmoplastic ameloblastoma）並接受邊緣性部分下頷骨切除手術（marginal mandibulectomy）之四十三歲女性。術後三年，胸部電腦斷層顯示產生多處肺結節。我們藉由胸腔內視鏡輔助手術切下其中兩顆肺結節，其病理報告顯示為轉移的造釉細胞瘤，跟原發的位置有一樣的組織學特性，並沒有看到細胞的異生（cellular atypia）。而此病例的原發位置並沒有產生腫瘤復發的跡象。在胸腔內視鏡輔助手術後，此病例並未接受其他針對轉移性造釉細胞瘤之治療，而在接下來兩年的臨床追蹤肺轉移並未進一步進展。
並列摘要
Ameloblastoma is an uncommon benign, locally aggressive odontogenic neoplasm that accounts for approximately 1% of all tumors and cysts of the jaw. Despite the propensity for local recurrence, ameloblastoma rarely exhibits malignant behavior, but disseminates (malignant ameloblastoma), with the lung as the most common metastatic site. Herein, we report the case of a 43-year-old woman who had desmoplastic ameloblastoma of the mandible and underwent marginal mandibulectomy for removal of the primary tumor. Three years following surgical resection, multiple nodules were found incidentally in the bilateral lungs on computed tomography scan of the chest. The diagnosis of metastasizing ameloblastoma without cellular atypia was confirmed pathologically after wedge resection of 2 of the nodules by video-assisted thoracoscopic surgery. There was no local recurrence at the primary site along with the occurrence of pulmonary metastasis. This patient received follow-up without immediate treatment for the metastasizing ameloblastoma and, in the following 2 years, no radiological progression of the pulmonary metastasis was seen.
延伸閱讀
- Chou, Y., Chu, Y. C., Chen, F. F., & Hsiue, T. R. (2002). 肺部結節性類澱粉沉著症仿似轉移性惡性病變：病例報告. 胸腔醫學, 17(3), 276-281. https://www.airitilibrary.com/Article/Detail?DocID=10239855-200209-17-3-276-281-a
- Tsai, C. W., Chang, G. C., & Hsu, J. Y. (2005). 原發不明之肋膜及肺部轉移性惡性黑色素細胞瘤－一病例報告及文獻回顧. 胸腔醫學, 20(1), 81-85. https://doi.org/10.29806/TM.200502.0012
- Huang, Y. Z., Chu, K. A., Ou, T. Y., Wu, K. S., Fu, T. Y., & Lai, R. S. (2014). 肺腺纖維瘤：罕見良性肺部結節－病例報導. 胸腔醫學, 29(3), 152-159. https://www.airitilibrary.com/Article/Detail?DocID=10239855-201406-201405160018-201405160018-152-159
- Chen, C. W., Huang, T. H., Chang, H. Y., & Chen, C. W. (2018). 一個多發性肌炎患者的肺微血管瘤病變：病例報告及文獻回顧. 胸腔醫學, 33(5), 190-196. https://www.airitilibrary.com/Article/Detail?DocID=10239855-201810-201809270005-201809270005-190-196
- Chang, L. H., Ho, S. Y., Wang, B. Y., Lin, S. H., Tsai, C. F., & Lin, C. H. (2018). 以肺腫瘤和雙側肺門及縱膈腔淋巴結腫大為表現的碳末沉著症：病例報告與文獻回顧. 胸腔醫學, 33(4), 156-162. https://www.airitilibrary.com/Article/Detail?DocID=10239855-201808-201807230006-201807230006-156-162