Hypoproteinemia Associated with a Gigantic Odontogenic Tumor: A Report of 2 Cases.

Tadashi Kawai, Toshimi Chiba, Kei Onodera, Naoko Tsunoda, Yuko Komatsu, Shuu Suzuki, Yuki Saito, Shintaro Kogi, Yasunori Takeda, Hiroyuki Yamada
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Abstract

BACKGROUND Hypoproteinemia is caused by a decrease in protein level in the blood. This report describes 2 cases of hypoproteinemia associated with a gigantic odontogenic tumor. CASE REPORT Case 1, a 65-year-old man, visited our hospital with the chief concern of swelling in the right mandible, approximately 100 mm in diameter, and ameloblastoma was diagnosed. Abscess drainage was observed in the fistula of the tumors. Total protein and albumin levels were low before surgery. Hemimandibulectomy was performed under general anesthesia. The final pathological diagnosis based on the specimen was ameloblastic carcinoma. After surgery, the total protein and albumin levels improved and remained stable 6 months after the operation. At 21 months after surgery, there were no signs of recurrence. Case 2, a 60-year-old woman, visited our hospital with a chief concern of swelling in the left mandible, approximately 100 mm in diameter, and ameloblastoma was diagnosed. Abscess drainage was observed in the fistula of the tumors. The patient had a history of hypoproteinemia; preoperative levels of total protein and albumin were low, and edema of the body was observed before surgery. Hemimandibulectomy was performed under general anesthesia. The final pathological diagnosis based on the specimen was ameloblastoma. After surgery, the total protein and albumin levels improved, and remained stable 6 weeks after surgery. There were no signs of recurrence 9 months after surgery. CONCLUSIONS These 2 cases indicate the possibility that hypoproteinemia can be caused by plasma leakage from fistulas associated with gigantic odontogenic tumors.

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低蛋白血症伴巨大牙源性肿瘤2例报告。
背景:低蛋白血症是由血液中蛋白质水平降低引起的。本文报告2例伴巨大牙源性肿瘤的低蛋白血症。病例1,65岁男性,以右下颌骨肿大,直径约100mm就诊,诊断为成釉细胞瘤。肿瘤瘘管处可见脓肿引流。手术前总蛋白和白蛋白水平较低。全麻下行半下颌管切除术。最终病理诊断为成釉细胞癌。术后总蛋白和白蛋白水平有所改善,术后6个月保持稳定。术后21个月,无复发迹象。病例2,一名60岁女性,以左下颌骨肿胀为主,直径约100mm,诊断为成釉细胞瘤。肿瘤瘘管处可见脓肿引流。患者有低蛋白血症史;术前总蛋白和白蛋白水平较低,术前观察到机体水肿。全麻下行半下颌管切除术。最终病理诊断为成釉细胞瘤。术后总蛋白和白蛋白水平有所提高,术后6周保持稳定。术后9个月无复发迹象。结论这2例病例提示低蛋白血症可能是由伴有巨大牙源性肿瘤的瘘管漏浆所致。
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