再発を繰り返し口底軟組織中に生じたエナメル上皮腫の1例

• Published in: 日本口腔外科学会雑誌 Vol. 64; no. 9; pp. 534 - 539
• Main Authors: 園部, 純也, 別所, 和久, 駒谷, 徹, 藤村, 和磨
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.09.2018
• Subjects: エナメル上皮腫; 再発; 歯原性腫瘍; 軟組織
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.64.534

Ameloblastoma is an odontogenic tumor with a high local recurrence rate, frequently recurring within the jawbones. However, when tumor cells remain in the periosteum, gingiva, or alveolar mucosa, recurrence in soft tissue near the jawbones has also been reported. We report a patient in whom ameloblastoma developed in the middle of the oral floor at the time of the 6th recurrence of ameloblastoma in the jaw. A 67-year-old woman visited our department to undergo treatment of a recurrent ameloblastoma. Contrast computed tomography showed a low attenuation area (35 × 30 mm) with internal heterogeneity in the left mandibular ramus. Magnetic resonance T1-weighted images revealed areas with signals nearly isointense relative to the muscle in the left mandibular ramus and the submucosal area of the oral floor. T2-weighted images showed a multilocular high-intensity area in the left mandibular ramus and a unilocular high-intensity area (10 ×7 mm) with internal heterogeneity in the submucosal area of the oral floor. With the patient under general anesthesia, segmental mandibulectomy with reconstruction using a vascularized free fibular flap and an excisional biopsy of the oral floor were performed. Histopathological examination revealed that both lesions in the mandible and oral floor were follicular ameloblastomas. As of 6 years from the operation to the present, no recurrence has been noted.