만성 하악골 골수염에서 발생한 편평상피세포암종
Squamous Cell Carcinoma Arising From Chronic Osteomyelitis Of The Mandible
박영욱, 김지혁, 이석근, 권광준, 장재현, 박정민,
소속 상세정보
박영욱 ( Park Young-Wook ) - 강릉대학교 치과대학 구강악안면외과학교실
김지혁 ( Kim Ji-Hyuck ) - 강릉대학교 치과대학 구강악안면외과학교실
이석근 ( Lee Suk-Keun ) - 강릉대학교 치과대학 구강병리학교실
권광준 ( Kwon Kwang-Joon ) - 강릉대학교 치과대학 구강악안면외과학교실
장재현 ( Jagn Jae-Hyun ) - 강릉대학교 치과대학 구강악안면외과학교실
박정민 ( Park Jung-Min ) - 강릉대학교 치과대학 구강악안면외과학교실
KMID : 0360120080300050465
Abstract
We experienced a rare case of oral squamous cell carcinoma arisen from gingival tissues overlying prolonged chronic osteomyelitis of the mandible. A 66 years old man complained of unhealed extraction sockets of left mandibular second premolar and first molar, and showed extensive leukoplakia in the gingival tissues of the same area. The inflammation of the socket granuloma became severe and extended into adjacent mandibular proper, resulted in diffuse suppurative chronic osteomyelitis of mandibular body, exhibiting irregular osteolytic changes of mandibular trabecular patterns in mottled radiolucent appearance. The leukoplakia was initially diagnosed under microscope, and the involved gingival tissues were radically removed. Thereafter, the gingival soft tissue inflammation involving the mandibular osteomyelitis was hardly healed for two years. During the period of repeated surgical treatments for the inflamed lesion, nine biopsies were taken sequentially. Until the eighth biopsy, there consistently showed the suppurative osteomyelitis with ingrowing gingival tissues into the bony inflammatory lesion. The gingival epithelium showed the features of leukoplakia but no evidence of malignant changes. However, the ninth biopsy, taken about 2 years after initial diagnosis, showed the early carcinomatous changes of the gingival epithelium. The neoplastic epithelial cells were relatively well differentiated with many keratin pearls, and infiltrated only into underlying connective tissues. So, we presumed that the present case of squamous cell carcinoma was caused by the persistent inflammatory condition of the mandibular osteomyelitis, and also suggest that the leukoplakia should be carefully removed in the beginning to prevent the neoplatic promotion of the chronic inflammation.
키워드
Squamous cell carcinoma;Leukoplakia;Chronic osteomyelitis;Neoplastic promotion
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