上顎歯肉に生じた紡錘細胞癌の１例

Abstract

A case of spindle cell carcinoma in the maxilla is reported. The patient was an 88-year-old woman. She was referred to our department because of swelling of the maxillary gingiva. A soft mass (35×30mm) with a rough surface was present in the left upper molar region. Since the tumor was diagnosed as a spindle cell carcinoma on histological examination of biopsy specimens, surgical excision was performed with the patient under general anesthesia. Histologically, the tumor contained squamous cell carcinoma and sarcomatoid regions with spindle-shaped tumor cells. The sarcomatoid regions were closely associated with those of squamous cell carcinoma. Immunohistochemical techniques were used to distinguish between epithelial and mesenchymal properties, and keratin was found in the sarcomatoid regions.Although no cancer was evident at the surgical margins, bilateral metastases were present in the cervical lymph nodes 2 weeks after operation. Neck dissection was performed. Soon after the operation, however recurrence and metastasis developed at the surgical margin of the initial operation and the left parotid area and disease progressed rapidly. General condition deteriorated and cachexy worsened. She died 8 weeks after the second operation.