口腔領域の非上皮性悪性腫ようの臨床的検討

Abstract

Clinico-statictical study was made using ten cases ofnon-epithelialmalignant tumors (sarcomas), excepting malignant lymphoma, of the oral region in the file of the First Department of Oral and Maxillofacial Surgery, Iwate Medical University, during the past 20 years from 1967 to 1986. They were approximately 3.2% of all patients with oral malignant tumors treated in our clinic during the same period. According to histological types and locations, 6 cases occurred in the mandible, i.e., 3 osteosarcomas, a chondrosarcoma, a myeloma and an Ewing's sarcoma, and 4 cases occured in the maxilla, i.e., 2 fibrosarcomas, an Ewing's sarcoma and a malignant fibrous histiocytoma (MFH). There were 4 males and 6 females ranging from 2 to 73 years old.Their initial symptoms were mostly swelling or formation of tumor mass of the oral cavity, and the durations from onset of the first symptom to a visits to our clinic were 1 week to 8 months. Clinically, the boundary of the oral tumors were well circumscribed in 4 of 6 mandibular cases. On the other hand, they were ill circumscribed in all maxillary cases. The tumors' surface appeared reddening in 8 cases, ulceration in 6 ewes and both in 5 cases.Radiographically, destruction of the jaws infiltrated by the tumors were widely and irregularly. The periosteal reactions were observed as spicula in 3 mandibulr cases. In 8 of 9 cases in which the tumor involved denturous areas, the periodontal membrane space was widened. The histological diagnosis for oral sarcomas were difficult, in which 7 cases could not be determined histological types at first biopsy.Surgery with chemotherapy and/or radiotherapy in 8 of 10 cases, and chemo-and radiotherapy in 2 cases wee performed. The prognoses were poor, and only 2 patients ofa mandibulr chendrosarcoma and a maxillary fibrosarcoma were alive without tumor for 10 and 14 years. The remaining 8 patients died, 4 were local recurrence, 4 had distant metastases.