上顎に発生した象牙質形成性幻影細胞腫の1例

• Published in: 日本口腔外科学会雑誌 Vol. 65; no. 10; pp. 661 - 666
• Main Authors: 福田, 正勝, 菊池, 建太郎, 井上, 勝元, 重松, 久夫, 星野, 都, 坂下, 英明
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.10.2019
• Subjects: 幻影細胞; 石灰化歯原性囊胞; 象牙質形成性幻影細胞腫
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.65.661

A 73-year-old man was referred to our department because of a maxillary swelling. An elastic-soft oval swelling, measuring 55×49 mm, was found on the gingiva of the left palate. CT imaging showed a clearly demarcated unicystic-like lesion measuring 60 × 60 × 50 mm in the left maxillary sinus. After establishing a clinical diagnosis of odontogenic cyst, a biopsy examination of the lesion was performed by two-channel endoscopic sinus surgery. The histopathological diagnosis was a suspected calcifying odontogenic cyst. Odontogenic epithelium with ghost cells was found in the part of the cyst wall. Although additional surgery was required, the patient did not want to undergo it. After 2 and a half years, the left upper jaw showed swelling. CT imaging demonstrated a solid lesion with internal calcification at the same site as the previously extirpated lesion. A biopsy was performed, and pathological examination showed odontogenic epithelium resembling ameloblastoma with many ghost cells. Maxillary sub-total resection was therefore performed. The pathological diagnosis was a dentinogenic ghost cell tumor (DGCT). We have reported a rare case of DGCT arising in the maxilla, associated with transition from the cystic type to solid type. The patient was followed for 5 years after the surgical intervention, had no recurrence, and is still being followed up.