胃腺癌牙龈转移的病例报告及文献复习

目的:探讨1例胃腺癌牙龈转移的诊断、治疗及预后情况,为临床上胃癌合并口腔肿物患者的诊断提供参考。方法:报道扬州大学附属苏北人民医院1例胃腺癌牙龈转移患者的临床表现、治疗过程及预后情况,同时结合文献对此类病例的临床特点与诊治进行回顾分析。结果:患者因“右侧下颌后牙区牙龈肿块6个月”来我院就诊,确诊胃腺癌病史1个月。经口腔活检,结合病史考虑为转移性腺癌(牙龈)。收入院后,择期行手术切除牙龈转移瘤,并进行术后化疗。患者目前伤口愈合良好。临床上此类患者较少见,一般胃癌发生口腔转移多为疾病晚期,预后较差,生存时间较短。结论:胃腺癌合并口腔转移病例在临床上较少见,其准确诊断应多结合病史、影像学及病理结果,患者多处于癌症晚期,预后一般较差。临床上对于胃癌患者的口腔肿物需予以重视,避免误诊。     

口腔转移癌(腺癌)2例及文献复习

口腔转移癌较少,据Meyer报告占口腔恶性肿瘤的1％。在口腔转移癌中50％以上是腺癌,且以转移到颌骨的较软组织为多。作者将两例转移癌的经过,结合近年来报告的文献作了讨论病例1,女性,59岁。1975年8月因食欲不振求诊,经详细检查无结果,同年10月出现食物通过障碍,呕吐而再次求诊。于1976年1月经纤维胃镜诊断为胃癌,两个月后行手术包括切除食道、贲门及作再建术。经过良好。据术中及组织病理学所见诊断为P_0H_N_2S_3第四期腺癌。既往史及口腔所见:于1976年2月发现1区牙龈肿胀,不久缩小未作处理。同年5月该区龈再次出现龈瘤状无痛性肿大,因有增大倾向,检查见1的近中到13的近中,以12区为中心的牙龈上形成拇指大、有     

涎腺癌的远处转移

本文报告涎腺癌远处转移者106例,占全部涎腺癌14.78％。远转部位以肺最多见占75％,其它依次为颅内、骨、肝和直肠。本文探讨涎腺癌发生远处转移的临床规律。不同病理类型、原发部位、临床分期之间的远处转移机率有着非常显著地差别(p<0.05～0.01)。发生远处转移与两个因素有着密切关系:①活检及多次手术增加远处转移的机会。②有复发灶及颈转移灶存在亦增加远处转移的机率。因此,对涎腺癌应尽可能避免术前活检、行术中冰冻切片、力争诊断治疗一期完成。第一次手术彻底性是防止局部复发和减少远处转移的关键。术前用化疗者远处转移发生率比未用化疗者远处转移率有显著地降低。因此,对于易发生远处转移的病理类型采用术前化疗较好。     

肿瘤转移到牙龈

恶性肿瘤向远位器官转移至牙龈已有报道,临床上转移病损常象良性肿瘤或炎症增生,甚至牙周脓肿。本文报道一例乳腺癌转移至牙龈。病人女性,44岁,乳腺根治术后经过X     

食管基底细胞样鳞状细胞癌转移至牙龈

肿瘤转移至口腔,尤其是口腔软组织极为少见。本文报道1例。 患者为63岁男性,曾患晚期食管癌并行姑息性食管切除术。来口腔门诊要求鉴定牙龈上逐渐增大的肿物。口腔检查见:下颌磨牙区舌侧牙龈上一突出的2cm×1.8cm大小的肉芽性出血肿物,有蒂,未发现其它部位损害及淋巴结肿大,未有溶骨性损害,未见远距离癌肿组织转移。切除后的食管癌诊断为基底细胞样鳞状细胞癌。切除的牙龈肿物主要为包含小基底细胞的未分化癌肿和鳞状成分。非常类似食管癌的组织学特征,进一步的免疫组织化学染色(抗生物素蛋白—生物素复合染色技术)确诊为食管基底细胞样鳞状细胞     

乳头状涎腺瘤恶变1例

乳头状涎腺瘤(sialadenoma papilliferum)是一种罕见的良性外生性涎腺肿瘤, 乳头状涎腺瘤发生恶变者非常罕见。本文报告1例发生于牙龈的乳头状涎腺瘤恶变病例, 通过对该患者进行相关临床检查, 影像学检查及组织病理学检查明确诊断, 术后随访8个月未见复发及转移。     

涎腺癌血道转移(附21例病例报告)

涎腺癌瘤的血道转移是一个十分重要的临床问题,是否存在着血道的转移不但会影响患者的预后,也是决定治疗方案的关键。近来由于肿瘤治疗学的水平不断提高,较好地控制了原发病灶,使患者的生命延长和检查诊断肿瘤的水平也不断提高,能够检查出过去无法检查出的隐匿转移灶。所以涎腺癌瘤     

颈淋巴结转移性甲状腺癌的超声诊断

目的 探讨甲状腺癌颈淋巴结转移的诊断特点。方法 对5例甲状乳头腺癌颈淋巴结转移病人进行分析。结果 （1）物理检查见肿块位于颈中份胸锁乳突肌下淋巴链平面（平面Ⅲ）,质软,活动好。甲状腺正常。（2）超声检查显示位于颈侧部界限清楚的囊性肿块和同侧甲状腺内的原发病灶。结论 转移至颈淋巴结的甲状腺乳头状腺癌可以表现为囊肿型,高分辨率的超声仪可以发现隐匿型甲状腺癌。     

睑板腺癌腮腺及下颌下区颈淋巴结转移1例报告

睑板腺癌常发生于上眼睑,转移至腮腺及下颌下淋巴结者较为少见,临床上需与腮腺原发肿瘤相鉴别。本文报告1例上眼睑睑板腺癌转移至腮腺及下颌下区淋巴结病例,为此类疾病的诊断及治疗提供指导。     

趋化因子CXCL12及其受体CXCR4在口腔癌研究中的进展

<正>口腔癌是指发生于口腔的恶性肿瘤,包括唇癌、牙龈癌、舌癌、软硬腭癌、颌骨癌、口底癌、涎腺癌和上颌窦癌以及发生于颜面部皮肤黏膜的癌症等。口腔癌是头颈部较常见的恶性肿瘤之一,具有局部侵袭力强,易向颈部淋巴结转移的特点,且颈部淋巴结转移对患者预后影响很大[1]。因此,研究口腔癌的侵袭、转移对提高患者的治愈率和生存率具有重要的意义。     

Mucinous adenocarcinoma of the temporal region initially diagnosed as temporomandibular disorders: a case report

Adenocarcinoma occurring in the temporal region has not previously been reported. We present a case of mucinous adenocarcinoma of the temporal region. A 62-year-old female patient was diagnosed as having temporomandibular disorders because of severe trismus and joint pain. Although trismus progressively worsened, there were no abnormal findings on diagnostic imaging studies including magnetic resonance imaging (MRI) and bone scintigraphy. As swelling of the temporal region was observed, biopsy was performed. Histologic examination showed chronic inflammation of the striated muscle. Approximately 6 months later, follow-up MRI demonstrated an ill-defined mass lesion in the infratemporal region extending to the intracranium. Histologic diagnosis of the biopsy showed that this mass lesion was moderately differentiated mucinous adenocarcinoma.     

Salivary mucinous adenocarcinoma of the mandible

Mucinous adenocarcinoma (MAC) is a malignancy rarely affecting the salivary glands, with fewer than 30 cases described in the medical literature. MAC is mostly observed in the minor salivary glands of the palate, and to date, no case of salivary MAC has been reported in the mandible. Identifying a salivary MAC may be both clinically and histopathologically challenging, as differential diagnosis must consider not only other salivary malignancies expressing a mucinous component but also metastases from MACs of the gastrointestinal tract, breast, and sweat glands that strongly resemble a salivary MAC on histopathology. We describe an 80-year-old man with a gingival overgrowth of the left mandible for the past 9 months, who was referred to our institution with an initial diagnosis of a periodontal reaction. On clinical examination, the mass mimicked a hyperplastic lesion; but after biopsy, the histopathologic pattern suggested a diagnosis of MAC. Herein, we present how comprehensive physical examination of the patient, immunohistochemistry study of the specimen, and radiological features helped in establishing the diagnosis of intraosseous salivary MAC, ruling out metastatic disease or other salivary neoplasms.     

Low-grade adenocarcinoma of the oral cavity: polymorphous or papillary?

Polymorphous low-grade adenocarcinomas are low-grade malignant salivary-gland neoplasms with a broad variety of architectural patterns. Whether papillary structures fall within this spectrum or whether they should lead to a diagnosis of papillary low-grade adenocarcinoma is a subject of debate. This problem was investigated by analyzing a series of 22 salivary gland neoplasms. It was concluded that papillary structures form part of the histologic spectrum of polymorphous low-grade adenocarcinoma but that there are also tumors with papillary structures as a single component. In most instances these are more properly classified as papillary cystadenocarcinomas. As the designation papillary low-grade adenocarcinoma has been used for polymorphous low-grade adenocarcinomas with papillary structures as well as for papillary cystadenocarcinoma, it is advocated that the diagnosis of papillary low-grade adenocarcinoma should be discontinued.     

Intracapsular carcinoma ex basal cell adenoma of the parotid gland

Malignant transformation of basal cell adenoma is extremely rare. We report the case of a 63-year-old Chinese woman, who had noticed a slowing growing mass in her right parotid gland with slight pain for 1 month. Based on physical and ultrasound examinations, a diagnosis of benign salivary gland tumour was made before the surgery. A frozen biopsy was performed, and the diagnosis was basal cell adenoma, with the tumour cells infiltrating the capsule. Routine histopathological examination was performed after the surgery, and a final diagnosis of intracapsular basal cell adenocarcinoma ex basal cell adenoma was made. The patient received a further total parotidectomy and recovered well without any evidence of facial nerve palsy. This case suggests that during frozen biopsy, adequate sectioning including the capsule should be made. With regard to the treatment, we suggest a complete excision of the tumour with tumour-free margins, without any additional auxiliary therapy.     

Breast metastasis around dental implants: a case report

Background Metastases to the oral cavity and to the jaws are rare; hence, the clinical manifestations of the oral metastasis lesion could frequently be simulating general pathologic entities, making the diagnosis a challenging process to the dental team. Local factors, such as trauma, have been observed to facilitate the growth of blood‐borne tumors. To this end, surgical procedures such as fixture placement might cause cancer cells to spread. Purpose Careful clinical examination is a valuable help in diagnosing oral lesions, which can improve the quality of life of patients and reduce the risks of oral complications. Materials and Methods A female patient was referred to the clinic with symptoms of irritation, swelling, and pain associated with implants in the mandible and the maxilla. Results Clinical examination, x‐ray, and histopathology revealed that the patients suffered from a metastatic lesion, primary tumor being an adenocarcinoma of the breast diagnosed at the same time. Conclusion Optimal clinical examination in conjunction with radiography and histopathology is a necessity in order to discover malignant lesions in time. Routine dental check‐ups must comprise more thorough soft‐tissue examination.     

Mandible metastasis as the initial manifestation of breast carcinoma--report of a case.

A case is presented in which the only positive subjective and clinical findings were numbness of the lower lip and chin, generalized tooth mobility with dull pain, and swelling of the right lower jaw. After an appropriate and careful workup, in conjunction with other medical colleagues, a definitive diagnosis of adenocarcinoma of breast metastasis to the mandible was made, which was confirmed by a histopathologic examination. Radiographs disclosed radiolucent change with an irregular and a moth-eaten appearance in the mandibular trabeculation and loss of the lamina dura of several teeth. As this case demonstrates, the diagnosis of metastatic disease of the jaws requires a high degree of diagnostic astuteness, because of the many possible clinical signs and symptoms which can be nonspecific and can resemble diseases of an inflammatory origin. Accordingly, a histologic evaluation is essential in establishing a definitive diagnosis. The case report emphasizes the need for consideration of metastatic disease in the differential diagnosis of unknown oral lesions, especially in the mandible.     

Lip paresthesia associated with a jaw mass

A case is reported in which mandibular swelling and lower lip numbness were the first signs of a metastatic adenocarcinoma of the lung. The development of paresthesia, with or without other oral symptoms, requires that a diagnosis of malignancy be considered until confirmed or ruled out by tissue biopsy. A thorough head and neck examination in all patients, especially in those whose history or habits may indicate increased risk of malignancy is necessary.     

Polymorphous low-grade adenocarcinoma: Glial fibrillary acidic protein staining in the differential diagnosis with cellular mixed tumors

Polymorphous low-grade adenocarcinoma is a recently recognized salivary gland carcinoma arising primarily within the oral cavity. Most of these tumors are readily diagnosed; occasionally, however, they may be confused histologically with cellular mixed tumors. The difficulty stems from the bland cytologic nature of cellular mixed tumors and their organizational diversity, together with the irregular pushing growth at their interface with adjacent soft tissues, on histologic examination. Because of this diagnostic problem, we evaluated the use of glial fibrillary acidic protein localization in the differential diagnosis of polymorphous low-grade adenocarcinoma and cellular mixed tumor. Twelve oral polymorphous low-grade adenocarcinomas (polymorphous low-grade adenocarcinoma) and twelve cellular mixed tumors were selected and stained for glial fibrillary acidic protein (glial fibrillary acidic protein) using a strept-avidin-biotin system and examined independently by each investigator. In addition, five tumors with limited material (three cellular mixed tumors and two polymorphous low-grade adenocarcinoma) from the consultation service of one author were evaluated using the same techniques. Two polymorphous low-grade adenocarcinoma stained positive in very focal areas and only in the epithelial component; staining did not occur in the stroma. Fourteen of fifteen mixed tumors focally to diffusely expressed glial fibrillary acidic protein. Only one tumor did not express glial fibrillary acidic protein. In mixed tumors with only focal staining, the most helpful differential diagnostic feature was positive staining of the mesenchyme-like cells adjacent to epithelial nests. We did not find this latter staining pattern in any of the polymorphous low-grade adenocarcinoma.     

Respiratory epithelial adenomatoid hamartoma of the maxillary sinus presenting as a periapical radiolucency: a case report and review of the literature

We report a case of respiratory epithelial adenomatoid hamartoma of the left maxillary sinus that initially presented as a periapical radiolucency involving the left maxillary first molar. Respiratory epithelial adenomatoid hamartoma is a rare lesion that occurs in the nasal cavity, paranasal sinuses, and nasopharynx. Most cases are found in the nasal cavity associated with the posterior nasal septum. Involvement of the maxillary sinus is very unusual, and only one other report of a respiratory epithelial adenomatoid hamartoma involving the maxillary antrum was found in a search of the literature. The current case is additionally unique as it was initially detected in the course of a dental examination. Awareness of this lesion is important because inverted schneiderian papilloma and adenocarcinoma may be included in the histopathological differential diagnosis. Conservative surgical removal is curative and recurrence has not been reported.