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口底に認めた脂肪腫の１例
中村, 圭佑;坂田, 健一郎;佐藤, 淳;羽藤, 裕之;村井, 知佳;大賀, 則孝;松田, 彩;間石, 奈湖;樋田, 京子;北川, 善政
Permalink : http://hdl.handle.net/2115/86848
KEYWORDS : 脂肪腫;口底;認知症;高齢者;lipoma;floor of the mouth;dementia;the elderly
Abstract
【緒言】口腔領域における脂肪腫の発生頻度は全体の約2 %と報告されている．発生部位は頬粘膜，舌，口唇，歯肉の順に多く口底での発生は比較的まれで，2 cm以下が半数を占める．著者らは認知症を伴う70歳代女性の口底脂肪腫を経験した．
【症例と経過】近医歯科より口底部腫瘤の精査を勧められ，当科を紹介された．左側口底部に30×25㎜大の腫瘤病変を認めた．表面粘膜は滑沢で，境界明瞭，弾性軟で，粘膜下の腫瘤の一部は黄色を呈していた．病変はCTで境界明瞭な低吸収域，USでは高エコー領域を認めた．認知症および腫瘤病変により口腔清掃不良状態で，残根の歯を多数認めた．口底良性腫瘍の臨床診断の下，腫瘍摘出術を施行した．摘出物は充実性で，薄い被膜に包まれていた．病理組織学的診断は脂肪腫であった．
【結語】本病変の増大時期は認知症のため不明であったが，腫瘤の増大により口腔清掃不良を引き起こしていた．症例によっても異なるが脂肪腫を含め口腔内の環境を悪化させている原因は可能な限り早期の手術が望ましいと考えられた．
[Introduction] The incidence of lipoma in the oral region is reported to be about 2% of the total. The major sites of occurrence are buccal mucosa, tongue, lips, and gingiva, respectively, and the occurrence on the floor of the mouth is relatively rare. The size of tumor is usually with 2 cm or less . We experienced a lipoma of oral floor in a woman in her 70s with dementia. [Case and course] Her family dentist recommended a detailed examination of the oral floor mass and was referred to our department. She had a mass with 30 × 25 mm diameter on the left oral floor. The superficial mucosa was normal with smooth, well-defined. The mass revealed elastic and soft. The submucosal masss revealed yellowish color. The lesion showed a well-defined low absorption area on CT and a high echo area on US. Due to dementia and mass lesions, her oral hygiene was poor and many residual root teeth were identified. Under the clinical diagnosis of a benign tumor on the floor of the mouth, tumor resection was conducted. The exci sed material was a solid tumor wrapped in a thin capsule. The histopathological diagnosis was lipoma. [Conclusion] The time of growth of this lesion was not clear owing to her medical problem with dementia; however, the growth of the tumor caused poor oral hygiene. Although it depend on each case, we sugget that it is desirable to operate this kind of lipoma as early as possible. Although it depends on the case, it is consider ed desirable to have surger y as early as possible as the cause of deterioration of the oral environment including lipoma.
[Introduction] The incidence of lipoma in the oral region is reported to be about 2% of the total. The major sites of occurrence are buccal mucosa, tongue, lips, and gingiva, respectively, and the occurrence on the floor of the mouth is relatively rare. The size of tumor is usually with 2 cm or less . We experienced a lipoma of oral floor in a woman in her 70s with dementia. [Case and course] Her family dentist recommended a detailed examination of the oral floor mass and was referred to our department. She had a mass with 30 × 25 mm diameter on the left oral floor. The superficial mucosa was normal with smooth, well-defined. The mass revealed elastic and soft. The submucosal masss revealed yellowish color. The lesion showed a well-defined low absorption area on CT and a high echo area on US. Due to dementia and mass lesions, her oral hygiene was poor and many residual root teeth were identified. Under the clinical diagnosis of a benign tumor on the floor of the mouth, tumor resection was conducted. The exci sed material was a solid tumor wrapped in a thin capsule. The histopathological diagnosis was lipoma. [Conclusion] The time of growth of this lesion was not clear owing to her medical problem with dementia; however, the growth of the tumor caused poor oral hygiene. Although it depend on each case, we sugget that it is desirable to operate this kind of lipoma as early as possible. Although it depends on the case, it is consider ed desirable to have surger y as early as possible as the cause of deterioration of the oral environment including lipoma.
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