下がく前歯部歯肉に発生したゆうぜい状がんの１例

Abstract

Verrucous carcinoma was first described by Ackerman in 1948, and is generally referred to as “Ackerman tumor”. In Japan, a case was reported in 1967 by Kozaki et al, followed by a report by Ishikawa et al, in 1970. This tumor is regarded clinically and histopathologically as a squamous cell carcinoma with relatively benign characteristics. It is relatively rare and found in the oral cavity region.The authors reported a case of verrucous carcinoma in a 73 year old male. The patient felt irritation in his lower anterior alveolar region with his tongue, one month prior to visiting the Oral Surgery Dept. on October 23, 1980. Due to the lack of subjective symptoms, he failed to apply for a medical examination. At his first visit, his chief complaint as a slight increase in tumor. The case was examined at our clinic at the Department of Oral Surgery, School of Dentistry Higashi Nippon Gakuen University.Upon examination, the tumor was found to be a peduncular the last part of this sentence is not clear tumor with a relatively soft and wide base. It extended over the lower anterior alveolar crest region from 3 to 4 mediodistal region. It reached the mucolabial fold on the lip side and touched the mouth floor mucosa on the tongue side with a surface that resembled califlower. The tumor was suspected to be a gum papilloma or possible carcinoma and was extirpated. After extirpation of the left glandula submandibularis and the gum and alveolar process from 3 distal region to 4 distal region in a lump, ilium transplantation into the region was conducted. Four years and 8 months after the operation the recovery course may be considered favorable.Pathohistologically, the tumor was a papillary proliferation of stratified epithelium accom panied by slender connective tissues. Rather than penetrating deeply into the lamina propria, it appeared as a papillary proliferation of the epithelium in a downward direction. The point of the leading portion of the proliferation base was higher than the line drawn between the ends of the circumferential mucous menbrane. At the same time, a somewhat deep and narrow cleft was seen between the papillary epithelia, but no substance filling the cleft was seen. Histologically, the tumor comprised mainy of acanthosis with a slight degree of parakeratosis. In the basal layer atypia of epithelial tumor cells to a slight degree was seen. On the other hand the basement membrane was preserved but phlogocyte infiltration was intensive and destroyed the basement in places. Thus, the tumor was determined to be verrucous carcinoma from the histopathological diagnosis.