亮細胞齒源性癌－病例報告

Clear Cell Odontogenic Carcinoma: A Case Report

林鈞盛(Jiun-Sheng Lin) ； 鄭介原(Chieh-Yuan Cheng) ； 呂佳純(Chia-Chun Lu) ； 劉崇基(Chung-Ji Liu)

《臺灣口腔顎面外科學會雜誌》 19卷1期 (2008/03) Pp. 57-64

https://doi.org/10.7104/TJOMS.200803.0057

摘要

亮細胞齒源性癌(Clear Cell Odontogenic Carcinoma (CCOC))是一種罕見的齒源性惡性腫瘤，它具有局部侵犯性、較高的復發率、林巴及遠端轉移的特性。亮細胞齒源性癌主要發生於下顎骨內，發生於上顎骨較爲少見。發病年齡約在17至89歲之間、無性別差異。治療方式以外科手術爲主。本報告病例爲45歲男性，因下顎骨前牙區發現腫脹及疼痛至本院求診。環口放射攝影發現下顎骨前牙區之齒槽骨內，有放射線透過性影像大小約1.5×2.5公分，合併前牙牙根吸收。術後組織病理學檢查報告爲亮細胞齒源性癌，由於腫瘤本身擁有淋巴及遠端轉移的潛能，術後輔助性放射線治療，是必須要考量的。門診追蹤至今無局部復發及遠端轉移現象。因病例罕見全世界僅有40幾個病例，故提出報告討論。

關鍵字

亮細胞齒源性癌 ； 齒源性腫瘤

並列摘要

Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor that locally invasive, high local recurrent rate, regional lymph node and distant metastasis. CCOC mainly occurs in the mandible while maxillary CCOC represent approximately 1600, the patients were reported to have a wide range of age (arrange 17-89 years), the mean age at presentation was 58 years, no clear age predilection, CCOC develops equal frequency in both sexes, treatment for CCOC is surgical removal for first choice, we report a case of 45 years old male who suffered from painful swelling over anterior mandibular area for several weeks, panoramix examination revealed a well-defined margin radiolucent lesion with multiple roots resorption were noted, pre-operative biopsy revealed ameloblastoma, wide excision combined with partial mandibulectomy was performed and reconstructed with free fibular bone flap, final pathologic report shown clear cell odontogenic carcinoma, the post-op course was uneventful, the patient has been free of tumor recurrence till now, since the aggressive potential of this tumor, treatment protocols include tumor wide excision, neck dissection and post operative adjuvant radiotherapy are indicated.

並列關鍵字

clear cell odontogenic ； carcinoma ； odontogenic tumor