同一部位並存之口腔粘膜扁平苔癬與鱗狀細胞癌－病例報告

扁平苔癬(Lichen planus)為常見的口腔粘膜病變之一，由於其有惡性轉變的疑慮，因此患者必須接受定期追蹤，並依臨床變化施行病理檢查。回文獻，迄今尚未有口腔扁平苔癬惡性轉變病理機轉之直接證據。針對此項本文報告之病例為一75歲男性，主訴右下後方牙齦部位出現間歇性疼痛，牙齦表面並有潰瘍現象達半年，89年10月首次至本院求診，切片檢查為扁平苔癬並受藥物治療。患者持續門診追蹤，兩個月後因患無改善並有擴大及增生現象，故再次切片檢查，病理診斷證實為鱗狀細胞癌。隨後安排患者接受放射線治療，術後患者患部腫瘤消除，預後良好。由於臨床上扁平苔癬之長期多變且難以治癒，惡性轉變的實際病例也不多見，本病例屬罕見之扁平苔癬與鱗狀細胞癌同時並存之病變，本篇的目的除了報告此一特殊病例外，並以臨床及組織變化來分析此病例而且回顧文獻做一綜合性探討。

關鍵字

扁平苔癬；鱗狀細胞癌；惡性轉變

並列摘要

Lichen planus is a common lesion of oral mucosa. The suffered patient need to receive periodical follow up because of the possibility of malignant transformation, It is also needed to perform an incisional biopsy according to clinical change. Reviewing the literatures, there was no strong direct evidence to prove the mechanism of malignant transformation of oral lichen planus. Under the point, we report a case, 75 years old male, complaining of on and off pain on right posterior lower gingiva. The ulceration of gingival surface also was noted for about half year. He went to our department for first aid in October 2000.Histopathologic examination revealed lichen planus. He received rebiopsy 2months later due to the lesion grew larger. The histopathologic examination revealed squamous cell carcinoma. The patient received radiotherapy and the lesion got cure. The prognosis is well. Lichen planus has the potential of changeability clinically, high incidence rate, and difficulty of cure. It is not common that lichen planus transformed to squamous cell carcinoma, so we analyse the case according to the change of clinical feature, reviewing the literatures and discuss it comprechensively.

並列關鍵字

Lichen planus ； Squamous Cell carcinoma ； malignant transformation

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同一部位並存之口腔粘膜扁平苔癬與鱗狀細胞癌－病例報告

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