A case of adenosquamous carcinoma of the lower gingiva

DOI Web Site 6 References
  • NAKATA Akira
    Division of Dentistry and Oral Surgery, Akita University School of Medicine
  • FUKUDA Masayuki
    Division of Dentistry and Oral Surgery, Akita University School of Medicine
  • YAMASHITA Takashi
    Division of Dentistry and Oral Surgery, Akita University School of Medicine
  • HOMMA Takashi
    Division of Dentistry and Oral Surgery, Akita University School of Medicine
  • KUWAJIMA Seiichi
    Division of Dentistry and Oral Surgery, Akita University School of Medicine
  • TAKANO Hiroshi
    Division of Dentistry and Oral Surgery, Akita University School of Medicine

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  • 下顎歯肉に発生した腺扁平上皮癌の1例
  • カガク シニク ニ ハッセイ シタ セン ヘンペイ ジョウヒガン ノ 1レイ

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Abstract

Adenosquamous carcinoma is a malignant tumor that rarely occurs in the oral and maxillofacioal region. We report a case of adenosquamous carcinoma of the lower gingiva. A 81-year-old man visited our hospital because of swelling of the right lower gingiva in November 2009. A hemorrhagic tumor with induration of 41 × 36 mm was found in the right lower molar region, and histopathological examination of a biopsy specimen suggested a diagnosis of adenosquamous carcinoma expressing cytokeratin 7. Imaging studies revealed cervical lymph-node metastases and nodules in the lung. The clinical diagnosis was suspected to belower gingiva carcinoma （T4aN2bM1, Stage IVC） with an abnormally high level of serum carcinoembryonic antigen （CEA, 50.3 ng/mL）. In January 2010, tracheotomy, neck dissection, lower jaw segmental resection, and lower jaw reconstruction using a metal plate and pectoralis major myocutaneous flap were performed with the patient under general anesthesia. The postoperative serum CEA value decreased to 7.5 ng/mL. In the operative specimen, squamous cell carcinoma and a tubular structure were found, and PAS and Alcian blue stain were positive. The final histopathological diagnosis was adenosquamous carcinoma. He was progressing well and discharged without other treatment in February of the same year. Although pulmonary disease was not diagnosed, lung nodules gradually increased, and he died of respiratory failure in September 2012, 32 months after the operation.

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