アブストラクト（56巻1号：神奈川歯学）

神奈川歯学

Japanese

Title　： 原発不明上顎未分化多形肉腫の1例
Subtitle　： 症例・臨床報告
Authors　： 岩瀬博建1,2), 石川美香1), 加藤洋史1), 佐々木忠昭1)
Authors（kana）　：
Organization　： 1)宇都宮記念病院歯科口腔外科, 2)いわせ歯科口腔外科耳鼻咽喉科クリニック
Journal　： 神奈川歯学
Volume　： 56
Number　： 1
Page　： 37-44
Year/Month　： 2021 / 6
Article　： 報告
Publisher　： 神奈川歯科大学学会
Abstract　： 「緒言」 軟部腫瘍の組織分類は大きく変化しており, 2013年に改訂されたWHO分類では形態分類を中心にした分類から分子生物学的知見に基づいた分化細胞, 形質を盛り込んだ分類となった. 従来の悪性線維性組織球腫(malignant fibrous histiocytoma: MFH)の概念は完全に消失してしまい, 未分化多形肉腫(undifferentiated pleomorphic sarcoma: UPS)と分類された. UPSは中高年の四肢, 体幹や後腹膜の軟部組織に好発し, 頭頸部領域での発生は比較的希で全体の3～10%といわれている. 再発・転移の頻度も高く, 2年生存率が50～60%, 5年生存率で48%と報告されている. 遠隔転移の大半は肺で, リンパ節などへの転移は比較的少ないとされている. また顎骨原発での再発・転移も同様の報告をみる. 他部位から口腔領域へ転移した症例も報告されている. 今回われわれは口腔内症状を初発症状とした原発巣が明らかで無い上顎歯肉に発生した未分化多形肉腫の1例を経験したので報告する.
Practice　： 歯科学
Keywords　： 原発不明, 未分化多形肉腫 (UPS), 悪性線維性組織球腫 (MFH), 口腔領域

English

Title　： A Case of an Unknown Primary Site Undifferentiated Pleomorphic Sarcoma in the Maxilla
Subtitle　：
Authors　： Hirotate IWASE1,2), Mika ISHIKAWA1), Hiroshi KATO1), Tadaaki SASAKI1)
Authors（kana）　：
Organization　： 1)Department of Oral and Maxillofacial Surgery, Utsunomiya Memorial Hospital, 2)Iwase Dental & Oral Surgery and Otolaryngology Clinic
Journal　： Kanagawa Shigaku
Volume　： 56
Number　： 1
Page　： 37-44
Year/Month　： 2021 / 6
Article　： Report
Publisher　： Kanagawa Odontological Society
Abstract　： [Abstract] Primary and metastatic undifferentiated pleomorphic sarcoma (UPS) of the oral cavity is very rare. However, several cases of UPS originating in the skull and neck with direct extension into the oral cavity have been reported. Cases of patients with metastasis to the oral cavity from other sites have been published. We report the case of a patient who had UPS in the maxilla and in whom the primary site was unknown; oral symptoms were the first symptoms in this patient. A 72-year-old man was referred to our department with a suspicion of malignant tumors based on a biopsy of gingival swelling in the left maxilla. Imaging study: Panoramic radiography showed no apparent bone resorption. It admitted approximately a 20-mm tumor that exhibits a slight boundary unclear soft-tissue concentration of the left maxillary gingiva by contrast computed tomography (CT), but a significant contrast effect could not be pointed out. In addition, simple bone mode CT showed slight bone resorption in the adjacent left maxillary cortical bone. Magnetic resonance imaging findings: T1-weighted contrast image showed a mass indicating a uniform enhancing effect around the left maxillary canine. Positron emission tomography/CT findings: There was significant abnormal accumulation of irregular tumor and FDG to the left maxillary gingival that are obscured heterogeneously by contrast boundaries. The SUVmax value was 9.9. Moreover, the SUVmax value was 5.6 for the cervical spine, 7.5 for the thoracic spine, 4.1 for the lumbar spine, 6.8 for the ribs, 4.4 for the ilium, 4.8 for the ischium, and 6.9 for the pubis. Multiple bone-melting images and abnormal accumulation of FDG were observed. Preoperative diagnosis was malignant maxillary tumor and multiple malignant bone tumors. In consideration of the patient's quality of life, we performed partial resection of the left maxilla. Histopathological diagnosis: UPS. The patient's postoperative oral condition was good. He could eat using maxillo partial prosthodontics. He was treated for multiple malignant bone tumors and died owing to these conditions eight months after his first examination.
Practice　： Dentistry
Keywords　：