原发性下颌骨鳞状细胞癌-附2例报道

目的：探讨原发性下颌骨鳞状细胞癌的临床特点,为其早期诊治提供参考。方法：对2006-2009年原发于下颌骨的2例鳞状细胞癌的临床表现、治疗及预后进行回顾性分析。结果：2例原发性下颌骨鳞状细胞癌的患者均为老年男性,分别有下颌骨病变区域肿胀、疼痛、患侧下唇感觉异常病史。临床检查病变区域牙龈无红肿,无增生物。全口曲面断层片可见下颌骨病变区为界限不清的溶骨性改变。骨扫描未见全身其它骨骼病变。胸片及腹部B超检查均未见其它病灶。结论：原发性下颌骨鳞状细胞癌的临床特点不明确,应提高对该病的认识,以达到早期诊断和治疗的目的。     

原发性下颌骨鳞状细胞癌1例报告及文献复习

原发性下颌骨鳞状细胞癌由于早期缺少特征性的临床表现,诊断较为困难。本文报告1例原发性下颌骨鳞状细胞癌,并复习相关文献,就其组织来源、临床表现、诊断、治疗及预后进行讨论。     

口腔颌面部两侧对应部位多原发癌

口腔颌面部多原发癌是指同一患者在同时或不同时期内出现两个或两个以上的原发性癌瘤。可同时发生于口腔颌面部 ,也可与身体其它部位同时发生 ,但发生于口腔两侧同一部位的多原发癌较少见 ,我科 1985年～ 1995年收治 4例 ,现报告如下。　　一、病例介绍病例 1,男 ,43岁。患者 1天前偶然发现左侧下颌颊侧牙龈有一溃烂面 ,无痛及不适 ,因 4年前右侧同一部位发生溃烂 ,经活检诊断为牙龈鳞状细胞癌一级 ,行牙龈癌及下颌骨部分方块切除。因病人有上次的经验随即来我院就诊 ,取活检为鳞状细胞癌一级 ,行同样手术 ,术后配合放疗和化疗。现随访 3年…     

放射性核素骨闪烁照像测定口腔鳞状细胞癌向下颌骨扩散

虽然口腔鳞状细胞癌能够早期发现,然而常难以控制。绝大多数治疗失败是由于原发部位局部复发。因此,就需要有一种方法能精确地描绘出肿瘤向颌骨的局部扩散。本文用放射性核素骨闪烁照像诊断口腔鳞状细胞癌下颌骨的侵犯。     

原发性下颌骨中心性鳞状细胞癌─—附10例报告

原发性下颌骨中心性鳞状细胞癌—附１０例报告杨建平（１）胡勤刚（２）（１福建三明市第二医院口腔科３６６０００２南京市口腔医院颌面外科）～～～～～～～～～～～～～～～～～～～～原发性颌骨中心性鳞状细胞癌是指一类原发于颌骨内的上皮性肿瘤和（或）牙源性上皮包...     

大型头颈部手术的胃肠并发症

病例1 患者男性,60岁,活检证明为右颊粘膜鳞状细胞癌,经放疗和化疗失败。无消化性溃疡病史。行肿瘤切除及右侧颈清扫术,包括右下颌骨及右颊部全层切除。缺损区用皮桨作外层的游离腓骨血管骨移植修复,舌瓣作衬里。术后2周出现严重黑大便,因颌间栓丝未能行内窥镜检查,4天后再次发生黑大便,即行剖腹探     

游离骨瓣重建上、下颌骨的适应证改变：UCLA17年620例患者的经验及放射性骨坏死的影响

该文旨在介绍UCLA游离骨瓣重建上、下颌骨的治疗指征。对1995—2012年间620例接受游离骨瓣颌骨重建的患者进行回顾分析。结果,最常见的手术指征为鳞状细胞癌（n=442）和下颌骨放射性骨坏死（ORN,n=73）。     

舌鳞状细胞癌侵袭和转移的研究进展

舌鳞状细胞癌是头颈鳞状细胞癌中最常见的恶性肿瘤,尽管医疗技术水平已经取得较大进步,但舌鳞状细胞癌患者的预后仍不理想,局部或区域性复发及颈部淋巴结转移仍为临床治疗的巨大挑战。文章介绍了与舌鳞状细胞癌侵袭和转移相关的一系列蛋白和基因、micro RNA、上皮间质转化和肿瘤干细胞行为的研究进展。随着对舌鳞状细胞癌侵袭和转移机制研究的不断深入,舌鳞状细胞癌侵袭和转移的生物学行为难题将有望被攻克。     

口腔鳞状细胞癌中郎格罕氏细胞的免疫组织化学研究

目的 本实验拟通过对郎格罕氏细胞在口腔鳞状细胞癌中的分布情况进行研究,从免疫上研究口腔鳞状细胞癌的发病机制,以期在免疫学上为口腔鳞状细胞癌的防治提供理论基础。方法 本研究采用S-100蛋白特异性标记郎格罕氏细胞,以免疫组织化学PAP方法对25例口腔鳞状细胞癌的上皮及间质内郎格罕氏细胞分布特点进行观察,计算郎格罕氏细胞出现频率。结果 口腔鳞状细胞癌病组织中郎格罕氏细胞数目为正常口腔粘膜组织的19.5倍。在细胞分布上,正常口腔粘膜组织中郎格罕氏细胞紧贴基底细胞层,而病变组织中的郎格罕氏细胞则散布于癌巢间的淋巴细胞中。所有组织标本中均有淋巴细胞浸润带出现。结论 本研究结果表明：1.癌上皮内郎格罕氏细胞与淋巴细胞相伴浸润,关系密切;2.间质内郎格罕氏细胞与淋巴细胞相伴浸润,关系密切;3.郎格罕氏细胞可能为抗原递呈细胞,在鳞状细胞癌免疫反应启动和调节中可能起着关键作用。     

基底细胞痣综合征一例报告

基底细胞痣综合征是一种常染色体显性遗传性疾病,其特点是多发性基底细胞痣,多发性颌骨囊肿,骨骼系统异常,颅内异常钙化等少见的综合征,我科于1985年11月收治一例,现报道如下:患者王××,女,20岁,住院号1408045。患者因上、下颌骨多发性囊肿,曾于1980年6月23日在本科行左侧上颌骨囊肿及双侧下颌骨囊肿摘除术。病理报告为上颌骨鳞状上皮内衬之纤维囊壁组织,双侧下颌骨牙源性囊肿。一年前自觉左侧上颌略膨隆,逐渐增大,今年5月又发现右侧下颌骨膨隆,时有口腔内溢脓。诊断为颌骨多发性囊肿术后复发,于     

Primary de novo intraosseous carcinoma of the mandible--report of a case and review of literature.

Primary intraosseous carcinoma (PIOC) is a rare malignant odontogenic neoplasm defined as squamous cell carcinoma arising within thejaws, having no initial connection with the oral mucosa and presumably developing from the residues of the odontogenic eptihelium. A 37yr old male patient reported with the complaint of pain and swelling in the right mandible and inability to open his mouth for the past six months. Examination revealed an expansile mass that involved the right mandible and extended from the 1st premolar region to the right angle of the mandible. The alveolar ridge was markedly expanded and was covered with intact, normal appearing mucosa. Radiographic examination revealed an ill-defined radiolucent area in the right body of the mandible, which extended to the lower border. Histopathologic examination revealed a well differentiated keratinizing squamous cell carcinoma. PIOC has no specific histopathologic features and can be definitively diagnosed only upon fulfillment of various criteria. These criteria were followed in our case and reported here for its rarity.     

Primary intraosseous carcinoma of the mandible with probable origin in an odontogenic cyst

Primary intraosseous carcinoma of the jaws (PIOC) is an uncommon lesion, but may not be as rare as commonly believed. Since the putative source of the epithelium giving rise to an intraosseous carcinoma is the epithelium involved in odontogenesis, these lesions are often designated as odontogenic carcinomas. These tumors may theoretically arise (1) from the lining of odontogenic cysts, (2) from other epithelial odontogenic tumors, or (3) de novo from presumed odontogenic rests. While not included in most classifications of PIOC, it appears logical to also include intraosseous mucoepidermoid carcinomas as a fourth type of PIOC. A case of primary intraosseous squamous cell carcinoma of the mandible, with evidence of origin in an odontogenic cyst, is presented. The recent literature on carcinomas arising in jaw cysts is reviewed.     

牙源性角化囊性瘤恶变1例

牙源性角化囊性瘤（KCOT）是一种常见的颌骨牙源性囊性病损,临床上牙源性角化囊性瘤复发常见,而恶变较少见。本文报道1例由牙源性角化囊性瘤恶变为原发性骨内鳞状细胞癌的病例。     

Malignant transformation of peripheral ameloblastoma

A peripheral (extraosseous) ameloblastoma was excised from the maxillary left tuberosity of an 82-year-old man. It recurred twice over a 5-year period, once as squamous cell carcinoma and again as undifferentiated carcinoma. Analysis of the literature suggests that peripheral ameloblastomas may have the same potential for malignant transformation as intraosseous ameloblastomas.     

34例下颌骨中心性癌临床、病理及预后分析

目的： 回顾分析下颌骨中心性癌的临床、病理以及预后特点。方法： 纳入2010—2015年于我院口腔颌面-头颈肿瘤科接受手术治疗的下颌骨中心性癌患者的基本信息、临床治疗信息、影像学信息、病理学信息、随访记录,采用SPSS17.0软件包对数据进行统计学分析。结果： 最终纳入36例患者,其中34例随访信息完整。随访患者中,男22例,女12例;年龄31~60岁23例,>60岁11例;有既往吸烟史13例,有既往酗酒史4例。瘤体最大直径中位值为4 cm,瘤体最大直径≤4 cm 21例,瘤体最大直径>4 cm 13例。病理报告提示9例存在同期淋巴结转移,所有术区切缘均为阴性。28例接受术后放疗,9例在随访期间死于肿瘤局部复发或肿瘤远处转移。结论： 手术是治疗下颌骨中心性癌的主要措施。瘤体位于下颌骨体部以外,同期肿瘤淋巴结转移的患者具有较高的术后肿瘤局部复发几率。既往酗酒史对肿瘤术后远处转移有一定促进作用,瘤体最大直径>4 cm的患者,总体预后较差。     

Squamous-cell carcinoma arising from an odontogenic cyst--the importance of computed tomography in the diagnosis of malignancy

Primary intraosseous carcinoma of the mandible is rare, and when it occurs often arises within or closely associated with an odontogenic cyst. The purpose of this article is to show the role of computed tomography (CT) in the early detection of carcinomatous changes, because of its specificity in establishing the nature of the lesion. An unusual case of a squamous cell carcinoma that arose in an odontogenic cyst is described. The appearance on the panoramic radiograph was suggestive of a benign cystic lesion in the left side of the mandible, but when a CT scan was performed, the appearance of the lesion was compatible with malignancy. Histopathological analysis confirmed the suspicion of a squamous cell carcinoma, but without CT investigation it would be impossible to demonstrate that carcinomatous change had developed from a cystic lesion.     

Central carcinoma of the jaws. A radiography and pathological analysis of 36 cases]

Records of 36 cases of central carcinoma of the jaws were collected, including 25 cases of squamous cell carcinoma; 9 cases of salivary gland carcinoma; one case of undifferentiated carcinoma and one case of basal cell carcinoma. The correlation between roentgenographic appearance and the histopathologic types are: (1) most lesions of osteolytic destruction are primary intraosseous carcinoma of the jaws (14/16); (2) most lesions of multilocular destruction are salivary gland carcinoma (8/11); (3) most lesions of unilocular destruction are malignant change of odontogenic cysts (7/9). Among 25 cases of squamous cell carcinoma, 7 cases are malignant change of typical keratocyst; 3 cases are similar to dentigerous cysts; 7 cases though show diffuse osseous destruction, they partly have characters of keratocyst in light microscope. So, the authors suggest that perhaps more central carcinomas of the jaws are arising from odontogenic keratocysts.     

Lymph node metastasis in spindle cell carcinoma arising in odontogenic cyst. Report of a case

The majority of primary intraosseous carcinomas of the jaws develop in preexisting odontogenic cysts. These tumors are usually well-differentiated keratinizing carcinomas with relatively good prognosis. Only two of 41 previously reported acceptable cases of primary intraosseous carcinomas from ex-odontogenic cysts were associated with cervical lymph node metastasis. Spindle cell carcinoma is an anaplastic dimorphic neoplasm with poor prognosis. It has a special predilection for the upper aerodigestive tract. This is to our knowledge the first report of spindle cell carcinoma developing in an odontogenic cyst. Cervical lymph node metastasis showing typical histologic features of spindle cell carcinoma was detected 8 months postoperatively. The prognostic implications of this finding are discussed in light of previously reported cases of intraosseous carcinoma arising in odontogenic cysts and of spindle cell carcinoma of the oral cavity.     

Primary intraosseous carcinoma of the mandible with probable origin from reduced enamel epithelium

This report describes a case of primary intraosseous carcinoma (PIOC) arising de novo in the mandible. The patient was a 74-year-old woman and an early PIOC was found incidentally during histopathological examination of the pericoronal tissue obtained at extraction of a deeply impacted third molar. The curetted soft tissues consisted of a microinvasive, keratinizing squamous cell carcinoma with scattered foci of carcinoma cells showing calcification; stromal osseous metaplasia was also observed. After additional treatment, the patient has remained free of disease for 2 years. Since the tumor was completely enclosed in the bone, the only identifiable source of the present PIOC is the reduced enamel epithelium. Despite its rarity, this case emphasizes the importance of careful histologic examination of all apparently innocuous dental follicles that are removed surgically.