An Unusual Occurrence of Epidermoid Cyst in the Buccal Mucosa: A Case Report with Review of Literature

Intraoral dermoid and epidermoid cysts are rare and account for less than 0.01% of all the cysts in the oral cavity. A large majority of the same arise in the floor of the mouth and infrequently in other sites. These cysts often remain asymptomatic for years until they reach a size that interferes with mastication, speech and rarely, breathing. However, they also can become acutely symptomatic if they are secondarily infected. We would like to report a case of a rare epidermoid cyst in the buccal mucosa with its differential diagnosis and a review of literature.     

颌下腺转移性多形性腺瘤1例

本文报道1例罕见的转移性多形性腺瘤,患者女性,30岁,左颌下腺及右锁骨上包块术后病检结果与患者8年前左颌下腺肿块切除后病检结果一致,病理形态均表现为良性多形性腺瘤。并结合文献报道,对转移性多形性腺瘤的临床病理特征、发病机制及防治方法等进行讨论。     

Tubercular Ulcer: Mimicking Squamous Cell Carcinoma of Buccal Mucosa

Tuberculosis is a chronic granulomatous disease that rarely affects oral cavity. Tuberculous lesions of the oral cavity are frequently overlooked in the differential diagnosis of oral lesions. The oral clinical presentation of tuberculosis may take many forms as ulcers, nodules, tubercular fissure, tubercular papilloma and tuberculomas. Diagnosis is confirmed by histopathology.     

腮腺多形性腺瘤81例回顾性分析

目的:比较腮腺多形性腺瘤区域性切除术与浅叶切除术两种术式的术后复发率及并发症发生情况,为临床合理选择术式提供参考依据。方法:总结2002-01—2008-06期间收治的腮腺多形性腺瘤81例,其中54例行腮腺区域性切除术,27例行腮腺浅叶切除术,随访3～9年。回顾性分析腮腺多形性腺瘤区域性切除术与浅叶切除术两种术式的术后复发率及并发症发生情况。结果:采用腮腺区域性切除手术的病例术后面瘫、Frey综合征、涎瘘的发生率均低于腮腺浅叶切除术,而肿瘤的复发率无明显差异。结论:区域性切除术手术创伤小,并发症少,还可以保存腮腺一定的功能,可作为腮腺多形性腺瘤临床治疗的首选术式。     

Epidermoid Cyst Arising in the Buccal Mucosa: Case Report and Literature Review

Epidermoid cysts are benign subcutaneous lesions, and the large majority of these cysts affect the floor of the mouth; however, the buccal mucosa is not a usual site of occurrence. To date, only 5 articles have been published with 6 cases of epidermoid cysts arising in the buccal mucosa. Therefore, the aim of this study was to describe the clinical, histopathological and immunohistochemical features of a case of epidermoid cyst located in the buccal mucosa. To our knowledge, this is the first report of an oral epidermoid cyst describing an intense foreign body gigantocellular inflammatory reaction against epithelial keratin component. Although the usual diagnosis for epidermoid cysts is based on histopathological findings, this case report addresses novel information regarding to the immunohistochemical pattern that may be found in these lesions.     

腮腺多形性腺瘤改良术式与传统术式的对比研究

目的:探讨采取美容切口,保留耳大神经、腮腺咬肌筋膜、腮腺导管和部分腮腺的改良腮腺切除术治疗腮腺多形性腺瘤的临床效果和方法.方法:将我院2000-2009年收治的腮腺多形性腺瘤患者120例分为2组,第1组采用美容切口,保留耳大神经、腮腺咬肌筋膜、腮腺导管和部分腮腺的改良腮腺切除术,第2组采用传统腮腺切除术.术后随访3～5...     

腮腺多形性腺瘤腺体切除范围的病理依据

目的　为腮腺多形性腺瘤腺体切除范围提供病理学依据。方法　通过显微镜对25例原发腮腺多形性腺瘤连续病理切片的观察,尤其是重点观察和测量腺瘤包膜外浸润、出芽生长情况,并探讨有无原发多中心分布。结果　①包膜外浸润及出芽生长的具体扩展范围为:0·09~0·29 mm,远小于腺体部分切除的安全边界(5~10 mm)。②原发多中心分布2例,但具有分散程度小、有统一融合包膜的特点。结论　腮腺多形性腺瘤瘤体外5~10 mm的腺体部分切除,可以达到根治的效果。     

Fas抗原在颊粘膜鳞癌中的表达及意义

为探讨Ｆａｓ抗原在颊粘膜鳞癌中的表达分布特点及其相关生物学意义,采用免疫组织化学方法,分别对５例正常颊粘膜、３４例颊粘膜鳞癌进行染色,观察Ｆａｓ抗原表达分布情况。结果发现,颊粘膜上皮生发层中Ｆａｓ抗原间断性弱表达,其它层细胞广泛表达;Ｆａｓ抗原表达与颊炽膜鳞癌的分化程度有关（Ｐ＜０．０１）,高分化颊癌中,Ｆａｓ抗原连续强阳性表达于癌细胞膜,低分化颊癌则呈间断性表达。由此提示,Ｆａｓ抗原不仅与颊粘膜上皮细胞的自然分化成熟衰老有关,而且还可能在颊粘膜鳞癌发生发展过程中参与分化与去分化的调节。     

环杷明对人腮腺多形性腺瘤细胞凋亡的影响

目的:探讨环杷明(cyclopamine)诱导人腮腺多形性腺瘤细胞凋亡的作用及其对Gli-2和Bcl-2表达的影响。方法:用10μmol∕L环杷明处理人腮腺多形性腺瘤细胞,48 h后倒置显微镜下观察细胞数量及形态变化;48 h后实时定量PCR检测实验组(环杷明组)和空白对照组、DMSO对照组的Gli-2、Bcl-2 mRNA表达水平差异;24 h后流式细胞术观察细胞凋亡。结果:人腮腺多形性腺瘤细胞用10μmol∕L环杷明作用48 h后倒置显微镜下可见细胞数量减少、细胞核固缩或碎裂、核仁变形等典型的细胞凋亡形态学变化;环杷明组与空白对照组、DMSO对照组相比,可以显著下调Gli-2、Bcl-2 mRNA表达(P<0.01);环杷明组的细胞凋亡率明显高于空白对照组和DMSO对照组(P<0.01)。结论:环杷明可诱导人腮腺多形性腺瘤细胞凋亡,其作用机制可能与下调Gli-2、Bcl-2 mRNA表达,活化细胞凋亡的线粒体途径有关。     

舌下腺癌在多形性腺瘤中1例

发生于舌下腺的癌在多形性腺瘤中极为罕见。本文报道 1例发生于舌下腺的腺样囊性癌在多形性腺瘤的病例。     

腮腺区复发性多形性腺瘤恶变侵犯颧骨1例报告

腮腺区复发性多形性腺瘤（recurrent pleomorphic adenoma,RPA）存在一定的恶变几率,但检索国内外文献未见侵犯颧骨的报道。本文报告1例腮腺区复发性多形性腺瘤恶变侵犯颧骨病例,并结合相关文献分析其临床、影像及病理特点,以进一步提高对该病的认识,减少误诊误治。     

腮腺多形性腺瘤术后复发11例临床分析

目的:探讨腮腺多形性腺瘤术后复发的相关因素及临床治疗方法。方法:对11例腮腺多形性腺瘤术后复发病例进行回顾性分析。结果:11例复发病例第2次手术分别采用浅叶切除术、腮腺全切术、扩大切除术。11例中有5例首次术后病理报告为富有细胞型多形性腺瘤,占45.5%;有2例恶变(18%)者术后已辅以放疗。二次手术后随访3～15年,除1例多形性腺瘤恶变者第2次手术后5年复发,其余病例二次术后均未见复发。腮腺多形性腺瘤复发与组织学类型及术式关系密切,富于细胞者易复发,手术越简单其复发率越高。结论:不规范的手术方法是导致腮腺多形性腺瘤复发的直接原因。     

p16、p21在涎腺多形性腺瘤及恶性多形性腺瘤中的表达

目的:研究涎腺多形性腺瘤及恶性多形性腺瘤中抑癌基因p16、癌基因rasp21的表达,探讨基因在涎腺多形性腺瘤及恶性多形性腺瘤发生发展中的作用。方法:应用免疫组化SABC法检测正常涎腺组织、多形性腺瘤及恶性多形性腺瘤中p16、p21的表达。结果:(1)p16表达:正常组阳性表达率为100%,良性组为95%,恶性组为82.5%。正常组与恶性组、良性组与恶性组相比存在显著性差异(P<0.05),正常组与良性组之间无统计学差别。(2)p21表达:正常组阳性表达率为0%,良性组为65%,恶性组为72.5%。正常组与良性组或恶性组相比均具有显著性差异(P<0.01),但良性组与恶性组相比无显著差别。结论: 1.p16基因变异在涎腺多形性腺瘤及恶性多形性腺瘤的发生发展中起一定作用;2.ras基因产物p21过表达可能对涎腺多形性腺瘤及恶性多形性腺瘤的早期发生起重要作用。     

50例颊粘膜鳞癌颈淋巴转移的相关因素分析

目的 :探讨颊粘膜鳞癌颈淋巴转移的变化规律及其临床意义。方法 :通过目微测器精确测量 5 0例颊粘膜鳞癌的厚度及浸润层次。对颊粘膜鳞癌颈淋巴转移的三个主要因素分别作相关回归分析。结果 :发现肿瘤厚度≤2mm ,均未浸及肌层 ,无一例发生颈淋巴转移 ;>2mm ,浸及肌层 ,颈转率高达 6 6 .0 0 %;两者颈转率间存在显著性差异。结论 :颊粘膜鳞癌厚度与颈转率之间呈显著正相关。     

Giant Parapharyngeal Space Pleomorphic Adenoma of the Deep Lobe of Parotid Presenting as Obstructive Sleep Apnoea: A Case Report & Review of the Diagnostic and Therapeutic Approaches

Introduction

Salivary gland tumours constitute about less than 4 % of all head and neck tumours. Pleomorphic adenoma, also called benign mixed tumour, is the most common tumour of the salivary glands. About 80–90 % of these tumours occur in the major salivary gland mainly parotid gland and 10 % of them occur in the minor salivary glands.

Aims and Methods

Aim of this case report is to discuss the unique case of giant parotid pleomorphic adenomas arising in the deep lobe involving the parapharyngeal space and difficulty in respiration at sleep during nights repoted at this institute. The patient was undergoing treatment for obstructive sleep apnea syndrome when she reported at this institute for disturbed sleep. Diagnosis was based on computed tomography scan and magnetic resonance imaging and cytology by means of fine needle aspiration biopsy.

Conclusion

An exhaustive pre-operative diagnostic algorithm is mandatory before approaching such lesions involving parapharyngeal space. Fine needle aspiration biopsy is, in our opinion, mandatory to avoid histological surprises. The surgical approach varies according to the location of the tumour and should provide excellent visibility with wide surgical exposure to secure local neurovascular structures.     

颊黏膜牙源性角化囊肿病例报告及文献回顾

牙源性角化囊肿是一种多发生于颌骨,呈侵袭性生长,且复发率高的牙源性良性病损。一类原发于颌骨外软组织,且具有OKC组织学特点的病变被称为外周性牙源性角化囊肿(peripheral odontogenic keratocyst, POKC)。本文报道1例右颊黏膜POKC,并就临床特点和起因等进行文献回顾。