舌白板症の経過観察中に生じた腺扁平上皮癌の1例

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  • 高井 美玲
    名古屋市立大学大学院医学研究科生体機能・構造医学専攻感覚器・形成医学講座口腔外科学分野 神戸大学大学院医学研究科外科系講座口腔外科学分野
  • 青木 尚史
    名古屋市立大学大学院医学研究科生体機能・構造医学専攻感覚器・形成医学講座口腔外科学分野
  • 前田 道徳
    名古屋市立大学大学院医学研究科生体機能・構造医学専攻感覚器・形成医学講座口腔外科学分野
  • 廣瀬 満里奈
    名古屋市立大学大学院医学研究科生体機能・構造医学専攻感覚器・形成医学講座口腔外科学分野
  • 重冨 俊雄
    医療法人徳洲会名古屋徳洲会総合病院歯科口腔外科
  • 渋谷 恭之
    名古屋市立大学大学院医学研究科生体機能・構造医学専攻感覚器・形成医学講座口腔外科学分野

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  • A case of adenosquamous carcinoma arising from preexisting leukoplakia of the tongue during follow-up
  • ゼツ ハクバンショウ ノ ケイカ カンサツ チュウ ニ ショウジタ セン ヘンペイ ジョウヒ ガン ノ 1レイ

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<p>Adenosquamous carcinoma (ASC) is defined as a tumor showing components of adenocarcinoma with well-formed ductal structures and squamous cell carcinoma (SCC) in the same lesion. Only a few cases of oral ASC have been reported. The prognosis of ASC is generally poor. On the other hand, it has been demonstrated that the malignant transformation of oral leukoplakia is generally associated with pathological findings of well-differentiated SCC with low-grade malignancy. In this paper, we report a case of ASC on the tongue that developed during follow-up for leukoplakia. A 66-year-old woman visited our hospital with a chief complaint of a white painful tongue lesion in November 2009. At presentation, a white rough surface lesion measuring 18 × 8 mm was noted on the right margin of the tongue. The lesion was diagnosed to be oral leukoplakia on initial biopsy. After 3 years 10 months of observation, an erosive lesion was found at the same region. The lesion was diagnosed to be SCC on a second biopsy, and partial glossectomy was therefore performed. The surgical specimen revealed that growth and invasion of nuclear chromatin-rich atypical cells including Alcian-blue-positive mucous cells and partially recognized ductal structures. Finally, the lesion was diagnosed to be ASC (pT1N0M0). As of 4 years and 2 months postoperatively, the patient is doing well, with no evidence of recurrence.</p>

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