下颌牙龈和前庭沟疣状黄瘤2例报道及文献回顾  

Verruciform xanthoma in mandibular gingiva and vestibular sulcus:two cases report and literature review

作　　者：杨梦馨 湛尧 宋治锋 YANG Mengxin;ZHAN Yao;SONG Zhifeng(Shanghai Stomatological Hospital,Shanghai 200031,China;Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases,Shanghai 200031,China;Department of Stomatology,Kunshan Hospital of Integrated Traditional Chinese and Western Medicine,Suzhou 215007,China)

机构地区：[1]上海市口腔医院,上海200031 [2]上海市颅颌面发育与疾病重点实验室,上海200031 [3]昆山市中西医结合医院口腔科,江苏苏州215007

出　　处：《口腔疾病防治》2025年第4期305-312,共8页Journal of Prevention and Treatment for Stomatological Diseases

摘　　要：目的 探讨口腔疣状黄瘤的临床和病理特点、诊断及鉴别诊断,为临床发现并正确诊治该病提供参考。方法 报道2例分别发生于下颌牙龈和前庭沟黏膜的疣状黄瘤病例,展示两个病例的临床表现特点及病理学特征,并结合既往文献对疣状黄瘤进行分析。结果 病例1为37岁女性,发现右下后牙牙龈粉色粗糙病损1个月,大小约14 mm×7 mm,质地坚韧,无疼痛,完善牙周基础治疗后于局麻下行病损切除术,术后病理检查显示上皮钉突细长,大量泡沫细胞填充于结缔组织乳头,诊断为疣状黄瘤。病例2为36岁男性,发现右下前牙前庭沟粉白色肿物3个月,大小约18 mm×10 mm,边缘不规则,质地中等,无疼痛,于局麻下行右下颌前庭沟肿物切除术,术后病理检查见上皮不全角化,钉突肥大伸长,固有层乳头区可见较多泡沫细胞,诊断为疣状黄瘤。文献复习结果表明,疣状黄瘤发病率为0.025%~0.094%,多发于50~70岁患者,男性发病率略高于女性,口腔内主要好发于硬腭、牙龈等,一般无浸润性。该病病因及发病机制尚不明确,临床表现缺乏特异性,故常被误诊为鳞状细胞乳头状瘤、寻常疣、尖锐湿疣、鳞状细胞癌或疣状癌等。其最终诊断依赖病理表现,疣状黄瘤的典型特征是上皮下结缔组织乳头中大量泡沫细胞聚集。结论 疣状黄瘤是一种罕见的口腔黏膜病变,其临床表现缺乏特异性,误诊率较高;临床上需与乳头状瘤、寻常疣、尖锐湿疣、鳞状细胞癌或疣状癌等疾病进行鉴别;最终诊断依靠病理检查;该病的主要治疗方式为手术切除,术后复发率低,且恶变少见。Objective To explore the clinical and pathological characteristics,diagnosis,and differential diagnosis of oral verruciform xanthoma,and to provide a reference for accurate clinical identification and treatment.Methods Two cases of verruciform xanthoma occurring on the gingiva and vestibular mucosa are reported.The clinical features and pathological characteristics of both cases are described in detail,and information from a literature review on verruciform xanthoma is provided.Results Case 1:a 37-year-old female patient presented with a pink,rough lesion on the gingiva of the right mandibular posterior teeth for one month.The lesion measured approximately 14 mm×7 mm,and it was firm and painless.After periodontal therapy,the lesion was excised under local anesthesia.Postoperative pathological examination showed that the epithelial nail protruded and was elongated,and a large number of foam cells filled the connective tissue papilla,leading to the diagnosis of verrucous xanthoma.Case 2:a 36-year-old male patient presented with a pale pink lesion on the right lower vestibular mucosa for three months.The lesion measured approximately 18 mm × 10 mm with irregular margins, and it was firm and painless. The lesion was excised under local anesthesia, and postoperative pathological examination showed parateratosis of epithelium, hypertrophy and elongation of the nail pro-cess, and more foam cells in the lamina propria papilla area. The diagnosis was xanthoma verrucosa. The results of a lit-erature review show that the incidence of verruciform xanthoma is 0.025%-0.094%, it primarily occurs in patients aged 50-70 years, the incidence in males is slightly higher than that in females, and it primarily occurs in areas of the oral cavity that include the hard palate and gums. It is generally non-invasive. The etiology and pathogenesis remain unclear. Clinically, verruciform xanthoma lacks specific characteristics, so these lesions are frequently misdiagnosed as other conditions, such as papilloma, common warts, condyloma acu

关 键 词：疣状黄瘤 口腔黏膜病变 下颌牙龈 前庭沟 人乳头状瘤病毒 寻常疣 尖锐湿疣 鳞状细胞癌 疣状癌 

分 类 号：R78[医药卫生—口腔医学]