背景:周围骨化性纤维瘤是指通常较小的牙龈的炎性或反应性增生。它由纤维组织中的硬组织形成,在欧洲和美国,“肿瘤病变”这个名字往往被频繁使用。临床上,周围骨化纤维瘤无痛,孤独,外生性,无柄,或有花梗,在女性中比男性中更常见。据我们所知,没有恶性肿瘤的报告。我们在此报告伴有鳞状细胞癌的巨大周围骨化性纤维瘤的病例。
方法:患者是一名83岁的日本妇女,她因牙龈肿块而来我院就诊。她被转介给我们进行检查和治疗,因为在另一家医院进行乙状结肠癌手术的气管插管很困难。测量的质量为83×58×35毫米,它从右上颌前磨牙牙槽区突出到口外区域。全景X线显示右侧上颌前磨牙区肿块的阴影,其中包括一些硬组织。计算机断层扫描显示肿块中的散射钙化图像。未进行磁共振成像,因为她的额头上有椎动脉夹和螺钉。鉴于上述发现,我们在局部麻醉下进行了活检.然而,我们无法绝对诊断增生鳞状上皮是牙龈假性癌性增生还是高分化鳞状细胞癌。因此,肿瘤切除术在全身麻醉下进行.病理诊断为周围骨化性纤维瘤伴鳞状细胞癌。手术后2年的随访期间没有复发的迹象。
结论:周围巨大骨化性纤维瘤合并鳞状细胞癌的病因尚不明确。因此,仔细观察是必要的。未来需要通过积累更多案件来审查这一问题。我们在此报告巨大的周围骨化纤维瘤巧合鳞状细胞癌的病例。
BACKGROUND: Peripheral ossifying fibroma is an inflammatory or reactive hyperplasia of the gingiva that is usually small. It is formed by hard tissue in fibrous tissue, and the name \"neoplastic lesion\" has tended to be used frequently in Europe and America. Clinically, peripheral ossifying fibromas are painless, solitary, exophytic, sessile, or pedunculated and more frequently found in females than in males. To the best of our knowledge, there have been no reports of malignant cases. We herein report the case of giant peripheral ossifying fibroma with squamous cell carcinoma.
METHODS: The patient was an 83-year-old Japanese woman who visited our hospital with a gingival massive mass. She was referred to us for an examination and treatment because it was difficult to perform tracheal intubation for surgery of sigmoid colon cancer at another hospital. The mass measured 83 × 58 × 35 mm, and it protruded to the extra-oral region from the right maxillary premolar alveolar region. Panoramic X-ray revealed the shadow of the mass in the right maxillary premolar region, which included some hard tissue. Computed tomography showed scattering calcified images in the mass. Magnetic resonance imaging was not performed because she had vertebral artery clips and screws in her forehead. Given the above findings, we performed a biopsy under local anesthesia. However, we were unable to diagnose absolutely whether the dysplastic squamous epithelia were pseudocarcinomatous hyperplasia of the gingiva or well-differentiated squamous cell carcinoma. Therefore, tumor resection was performed under general anesthesia. The histopathological diagnosis was peripheral ossifying fibroma with coincidental squamous cell carcinoma. There have been no signs of recurrence during follow-up as of 2 years after surgery.
CONCLUSIONS: The etiology of giant peripheral ossifying fibroma with squamous cell carcinoma is still not definite. Therefore, careful observation is necessary. It needs to be examined by accumulation of more cases in the future. We herein report the case of giant peripheral ossifying fibroma coincidental squamous cell carcinoma.