外傷潰瘍性嗜酸細胞肉芽腫－系列病例報告與文獻回顧

外傷潰瘍性嗜酸細胞肉芽腫是一種良性慢性口腔黏膜疾病。臨床上，常可見患者主訴有一疼痛、周圍隆起的火山口狀潰瘍。外傷潰瘍性嗜酸細胞肉芽腫致病機轉目前仍有爭議，患者於病灶區域常有外傷的病史，但有些並沒有相關紀錄。其病程可能是自我限制，在去除外傷原因後一段時間即會自行癒合；有時則會進展緩慢，甚至反覆復發。外傷潰瘍性嗜酸細胞肉芽腫有時難與其它潰瘍性口腔黏膜疾病做鑑別診斷，尤其是當病人有口腔惡性腫瘤之過往病史時，常需要活體切片檢查來作組織學上的確診。一旦確定診斷，對病灶加以局部藥物治療，必要時去除可能之局部刺激來源，觀察其自行復原。回溯過往文獻紀錄，並不建議以整體切除的方式來治療。但臨床上，患者卻常因爲疼痛難當，且疾病進展緩慢而要求直接切除。在此，我們提出2000~2010年間，共59例於台大醫院診斷爲外傷潰瘍性嗜酸細胞肉芽腫的病例，分析其臨床的病程進展與治療方式，希望能對此一疾病提供更完整的認識，同時協助建立臨床治療的準則。

關鍵字

外傷潰瘍性嗜酸細胞肉芽腫；口腔潰瘍；外傷；口腔癌

並列摘要

Traumatic Ulcerative Granuloma with Stromal Eosinophilia (TUGSE) is a chronic, benign, self-limiting, ulcerative oral mucosal lesion. Its pathogenesis remain unclear. Clinically, most patients present with a painful, crater-like ulceration with an elevated border in the oral mucosa. A history of trauma over the area may be related to the lesion, but some occur spontaneously. The lesion heal after removing the cause of trauma. In some cases, the lesion progresses slowly, and may recur. Differential diagnosis of TUGSE with other oral mucosal ulcerative disease is a clinical challenge, especially if the patient has a history of other malignancy in the oral cavity. Incisional biopsy is recommended in cases. After confirming the diagnosis, local medication, elimination of possible irritants, and regular follow-up is advised. In some cases, total excision may be required to treat persistent, intolerable pain.This case series reports 59 cases of TUGSE in the department of Oral and Maxillofacial Surgery and Oral pathology, National Taiwan University Hospital from 2000 to 2010. We analyzed the clinical course and treatment modality to improve the understanding of this lesion, and to establish clinical protocols for treatment.

並列關鍵字

TUGSE ； oral ulcer ； trauma ； oral cancer

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外傷潰瘍性嗜酸細胞肉芽腫－系列病例報告與文獻回顧

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