上顎造釉細胞癌－病例報告

Maxillary Ameloblastic Carcinoma-A Case Report

吳家佑(Jia-Yo Wu) ； 祁力行(Li-Hsing Chi) ； 彭伯宇(Bo-Yue Pemg) ； 林永和(Yun-Ho Lin)

《中華民國口腔顎面外科學會雜誌》 18卷2期 (2007/09) Pp. 131-140

https://doi.org/10.7104/CJOMS.200709.0131

摘要

造釉細胞癌是一種發生於顎骨內罕見的惡性腫瘤，尤其發生在上顎骨內者其惡性程度更大。目前僅有少數造釉細胞癌的病例被文獻所記載，因此對於該疾病的流行病學，治療方式及預後仍不是相當清楚。一般認爲，造釉細胞癌是生長快速並具有高度侵犯性的腫瘤，亦曾有發生遠端轉移的病例被報導。治療方式以廣泛性切除爲主，而頸部淋巴廓除術，放射線治療及化學治療所扮演的角色仍具有爭議。本病例報告之患者爲25歲男性，兩年前曾於它院接受上顎骨內造釉細胞瘤手術切除。就診的兩個月前患者口腔及鼻腔內開始有出血的情形，其理學檢查發現右側上顎頰前庭出現一無痛性腫脹，而磁振造影檢查顯示一實質性腫瘤充滿於右側上顎竇內。治療方式採腫瘤摘除合併周圍骨切除術，病理報告證實爲造釉細胞癌。病患於術後接受輔助性放射線治療。目前持續於門診接受追蹤，無復發及遠端轉移的情形。

關鍵字

造釉細胞癌 ； 造釉細胞瘤 ； 上顎骨

並列摘要

Ameloblastic carcinoma is a kind of rare malignant tumor of jaws. The epidemiology, treament modality, and prognosis are not well-understood because there are few literatures of ameloblastic carcinoma reported up to date. In general, ameloblastic carcinoma is a highly aggressive tumor with rapid growth, and cases of distant metastasis had been reported. Surgical resection is the most common treatment modality, while there is still controversy between neck dissection, radiotherapy, and chemotherapy. A 25-year-old male, who had been treated for ameloblastoma of the maxilla two years ago, visited our hospital due to bleeding in the nasal and oral cavity for 2 months. Physical examination disclosed a nontender mass in the right maxillary mucobuccal fold and the magnetic resonance imaging revealed a solid mass occupied in the right maxillary sinus. Enucleation combined with peripheral ostectomy was performed. Histologic examination of the excised lesion showed ameloblastic carcinoma. Postoperative adjuvant radiotherapy was carried out. Healing was uneventful and following up showed no evidence of recurrence and distant metastasis.

並列關鍵字

Ameloblastic carcinoma ； Maxilla