:A 50-year-old male had noticed a mass in the region of the maxillary left molar tooth since about 200X, but had left it untreated. Thereafter, it gradually became difficult for him to remove a maxillary denture, so he visited a nearby dental clinic and was referred to a municipal general hospital. A biopsy was performed and the histopathological diagnosis was fibrous epulis. The lesion was so huge that the patient was referred to the Department of Oral and Maxilla Facial Surgery of the National Defense Medical College for treatment. Clinical findings revealed a 42×35×30mm lesion in the region of the maxillary left molar tooth. Part of the denture was covered with the lesion and the patient was not able to remove it by himself. The tumor was excised under general anesthesia. The progress has been good without recurrence until now 5 years after the operation. :huge epulis(巨大エプーリス) ,fibrous(線維性) ,maxilla(上顎骨) ,denture(義歯) 〔Received Jan. 28, 2015〕 エプーリスは歯肉,歯根膜などの結合組織を発生母組織 とし,歯肉に発生した良性限局性腫瘤を総括した臨床的名 称であり,病理組織学的には肉芽腫性,線維性,血管腫性, 線維腫性,骨形成性,巨細胞性に分類される 1) 。発生部位 は歯肉で比較的早期に発見されることが多いため,その大 きさは大部分が 20 mm 未満であり,20 mm を超えること はまれであるとされている 2) が,増大した場合には腫瘍と の鑑別が必要である。今回われわれは長期にわたり放置さ れ,義歯の着脱が不可能となるに至った巨大な線維性エ プーリスの 1 例を経験したので,その概要を報告する。 患者:50 歳代,男性。 初診:200X 年 7 月。 主訴:上顎左側臼歯部の腫瘤。 既往歴:特記事項なし。 現病歴:200X−5 年頃に上顎左側臼歯部歯肉に腫瘤を 自覚したが,放置していた。腫瘤は徐々に増大し,200X * 自衛隊横須賀病院歯科診療部(主任:薄井秀樹部長) ** 防衛医科大学校歯科口腔外科(主任:佐藤泰則教授) *** 亀田総合病院歯科(主任:田村英俊部長) **** 東京西徳洲会病院歯科口腔外科(主任:佐野次夫部長)
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