Metastasizing Granular Cell Type Ameloblastoma with Intracranial Perineural Spread along the Abducens Nerve

惡性顆粒造釉細胞瘤併轉移性外旋神經周圍擴散

李振豪(Chen-Hao Li) ； 黃佩欣(Pei-Hsin Huang) ； 陳雅芳(Ya-Fang Chen) ； 陳慧娟(Hui-Chuan Chen) ； 黃馨頤(Shin-Yi Huang) ； 黃勝堅(Sheng-Jean Huang) ； 郭律廷(Lu-Ting Kuo) ； 杜永光(Yong-Kwang Tu)

《台灣癌症醫學雜誌》 2卷3期 (2015/09) Pp. 261-269

https://doi.org/10.6323/JCRP.2015.2.3.10

摘要

背景：造釉細胞瘤為一種具局部侵犯性的牙源性上皮良性腫瘤。有高復發率的傾向，少數可能會有轉移的情況。本例為第一個轉移性造釉細胞瘤以神經周圍擴散來表現之案例報告。病例報告：病患為一74歲的男性，於35年前診斷左下頷骨顆粒造釉細胞瘤。26年後，在手術部位發現局部腫瘤復發，故接受第二次手術切除。局部復發及顱內轉移性病變併外旋神經周圍擴散在第二次術後9年發生，經由原發部位及顱內腫瘤切片結果確診。討論：轉移性顆粒造釉細胞瘤在文獻上僅有五例，本文著重在討論顆粒造釉細胞瘤的特色及其神經周圍擴散轉移的可能致病機轉。

關鍵字

造釉細胞瘤 ； 顆粒細胞 ； 轉移 ； 神經周邊擴散 ； 外旋神經

並列摘要

Ameloblastomas are benign but locally invasive odontogenic epithelial tumors. They have a high tendency to recur, but a low incidence of metastasis. This is the first reported case presenting a perineural spread of metastasis in ameloblastoma. This is the case of a 74-year-old man with left mandibular granular cell type ameloblastoma diagnosed in 1978. Local recurrence occurred 26 years after tumor excision, and he again received surgical treatment. Distant metastasis with intracranial perineural spread along the sixth cranial nerve occurred 9 years after the second operation. The diagnosis was confirmed by excisional biopsy of the intracranial lesion and a needle biopsy of the left mandibular tumor. Only 5 patients have been previously reported with metastasized granular cell type ameloblastoma. We herein have presented a characterization of granular cell type ameloblastomas and a possible mechanism for perineural spread.

並列關鍵字

ameloblastoma ； abducens nerve ； granular cell type ； metastasis ； perineural spread