- 期刊
下顎骨內黏液表皮樣癌：二病例報告
Intraosseous Mucoepidermoid Carcinoma of the Mandible-Report of Two Cases
摘要
顎骨內黏液表皮樣癌是相當少見的頭頸部急性腫瘤，約佔所有黏液表皮樣癌的2-4%。在此提出兩個病例，第一例是48歲男性，主訴為左下第二大臼齒疼痛與咬合干擾，臨床上發現左下第二大臼齒動搖度極大，並且高出咬合平面，周圍下顎骨膨大。環口X光攝影中發現有一邊緣平順的單囊性放射可透性病灶，位於下顎左側上行支到第一大臼齒區，大小約5×3公分。臨床診斷為造釉細胞瘤或齒源性角化囊腫，但病理切片報告顯示為黏液表皮樣癌。後施以腫瘤切除及肩胛舌骨上頸部淋巴廓清術，並以腓骨皮瓣重建，術後追蹤半年無復發現象。第二例是67歲男性，主訴為右側臉頰及下顎骨腫脹約一年，它院病理切片顯示為黏液囊腫，環口X光攝影發現有一邊緣平順的多囊性放射可透性病灶，位於下顎右側上行支到右下大齒區，大小約6×4公分。臨床診斷為造釉細胞瘤，再次病理切片之報告為鈣化齒源囊腫，但臨床上仍懷疑為造釉細胞瘤，故施行下顎骨部分切除術，術後病理報告顯示為黏液表皮樣癌，追蹤兩年並無復發現象。
並列摘要
Central mucoepidermoid carcinomas are uncommon tumors, representing about 2 to 4% of all mucoepidermoid carcinomas. Two cases of central mucoepidermoid carcinomas of the mandible were reported in the article. The first case, the patient was a 48 years old male and he complained of toothache and occlusal interference of #37. During clinical examination, hypermobility of #37 and swelling over #37 vestibule were noted. The panoramic X-ray revealed a unilocular radiolucency with well-defined border from #36 to the L't ascending ramus and the size was about 5 x 3 cm. The clinical diagnosis were ameloblastoma or odontogenic keratocyst, but the pathological report was mucoepidermoid carcinoma. Then wide excision of tumor and ipisilateral supraomohyoid neck dissection were performed, and reconstructed with free fibular osseous flap. At half a year follow-up, the patient remains free of disease. The second case, the patient was a 67 years old male and he complained of swelling over R't cheek and mandible for 1 year. The pathological report by other hospital revealed mucocele. There was a multilocular radiolucency with well-defined border from #43 to R't ascending ramus and the size was about 6 x 4 cm. The clinical diagnosis was ameloblastoma and the result of the incisional biopsy was calcifying odongenic cyst. But the diagnosis of ameloblastoma can not be ruled out, so segmental mandibulectomy was performed. The final pathological report was mucoepidermoid carcinoma. At two-year follow-up, the patient remains free of disease.
延伸閱讀
- 蔡樂霖、曾志恩、邱智弘（2005）。下顎骨造釉細胞癌－病例報告。中華民國口腔顎面外科學會雜誌，16(2)，128-142。https://doi.org/10.7104/CJOMS.200509.0128
- Chang, Y. H., Sun, J. T., Huang, K. M., Lin, L. P., & Tsai, K. Y. (2013). 下顎骨骨內許旺式細胞瘤－病例報告. 臺灣口腔顎面外科學會雜誌, 24(4), 299-308. https://www.airitilibrary.com/Article/Detail?DocID=a0000494-201312-201401210028-201401210028-299-308
- Surianti, H., Chen, P. L., Hsue, S. S., Chang, C. M., Chang, I. P. Y., & Chen, Y. C. (2013). 下顎骨齒源性透明細胞癌－病例報告. 臺灣口腔顎面外科學會雜誌, 24(1), 38-49. https://www.airitilibrary.com/Article/Detail?DocID=a0000494-201303-201303260050-201303260050-38-49
- Chen, Y. L., Peng, C. Y., & Lu, M. Y. (2018). 原發性下顎骨內鱗狀上皮細胞癌－病例報告. 臺灣口腔顎面外科學會雜誌, 29(4), 268-276. https://www.airitilibrary.com/Article/Detail?DocID=a0000494-201812-201901110007-201901110007-268-276
- Biswas, R., Halder, A., Gangopadhyay, M., Bhutia, T. D., & Biswas, D. (2022). Myoepithelial Carcinoma of Mandible: A Rare Case with Literature Review. Journal of Medical Sciences, 42(4), 183-186. https://doi.org/10.4103/jmedsci.jmedsci_69_21