多列線毛上皮と埋伏過剰歯を伴った下顎骨嚢胞の1例

Abstract

症例は15歳男性．右下顎部に特に自覚症状はなかったが，20XX年，X線CT所見にて右下顎骨嚢胞が疑われ，MRI所見にて粘液様腫瘍が疑われた．全身麻酔下に病変部摘出術を行った．摘出物の病理組織学的所見は腺性歯原性嚢胞（ glandularodontogenic cyst：GOC）の可能性があるとの診断であった．GOCは臨床的に侵襲性発育を示すものがあり，それが術後の再発率が高い理由とされているが，報告例が少なく詳細は不明で，今後の症例の蓄積が必要である．

A 15-year-old male patient visited a dentist and was pointed out a supernumerary impacted tooth and radiolucent lesion in the right mandible on X-ray examination in October 20XX．The patient visited another dentist in a general hospital in March 20XX．The computed tomography showed the supernumerary impacted tooth，located between the right lower 4 and 5 tooth，connected to the cystic lesion，having multiple clusters，having a clear margin and hardened edge， located on the lingual side mandible between the right lower 2 and 5 tooth，and showing slight displacement from the right lower 2 to 5 tooth．The patient was referred to our hospital in April 20XX．On magnetic resonance imaging the lesion showed a high signal on T2W1, slightly higher signal than that of muscle on T1W1，and a higher hydrated signal in the lingual right mandible. It was suspected to be a mandibular cyst．Extirpation of the lesion, root amputation of the right lower 2 to 5 teeth，and extraction of the supernumerary tooth were performed in June 20XX． The histological diagnosis revealed a cystic lesion which had multiple layers of glandular ciliated epithelium，and thus was suspected to be a glandular odontogenic cyst．The postoperative course was uneventful for over 5 years after the operation．