Article

Ameloblastic Carcinoma: Case Report and Literature Review

Faculty of Dentistry, Laval University, Cité universitaire, Ste-Foy, Quebec.
Journal (Canadian Dental Association) (Impact Factor: 0.6). 11/2003; 69(9):573-6.
Source: PubMed

ABSTRACT Ameloblastic carcinoma is a rare malignant lesion with characteristic histologic features and behaviour that dictates a more aggressive surgical approach than that of a simple ameloblastoma. However, reliable evidence of its biologic activity is currently unavailable due to the scarcity of well-documented cases. It occurs primarily in the mandible in a wide range of age groups; no sex or race predilection has been noted. It may present as a cystic lesion with benign clinical features or as a large tissue mass with ulceration, significant bone resorption and tooth mobility. Because the lesion is usually found unexpectedly after an incisional biopsy or the removal of a cyst, a guide to differential diagnosis is not usually useful. The identifying features of ameloblastic carcinoma must be known and recognized by dental practitioners. Our understanding of the histologic features of ameloblastic carcinoma is somewhat vague. The tumour cells resemble the cells seen in ameloblastoma, but they show cytologic atypia. Moreover, they lack the characteristic arrangement seen in ameloblastoma. The clinical course of ameloblastic carcinoma is typically aggressive, with extensive local destruction. Direct extension of the tumour, lymph node involvement and metastasis to various sites (frequently the lung) have been reported. Wide local excision is the treatment of choice. Regional lymph node dissection should be considered and performed selectively. Radiotherapy and chemotherapy seem to be of limited value for the treatment of ameloblastic carcinomas. At the moment, there are too few reported cases to make a definite recommendation regarding treatment. Close periodic reassessment of the patient is mandatory.

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    • "Two patients with lung metastases were identified in the present study group (primary type) and the literature (secondary type). Ameloblastic carcinoma exhibits the histological features and behavior of malignancy, and therefore, definitive surgical treatment is required (20). In the literature the cure rate following extended jaw resection was 100% for primary and secondary tumors. "
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    ABSTRACT: The diagnosis of ameloblastic carcinoma is often difficult and the optimal treatment methods remain controversial. The current study retrospectively investigated the optimal diagnosis and treatment methods of 12 ameloblastic carcinoma patients at the West China Hospital of Stomatology, Sichuan University (Chengdu, China), and 20 patients selected from the PubMed database, were reviewed. The clinical features, diagnosis and outcome of the different treatments were evaluated. Ameloblastic carcinoma occurred in 12 out of a total of 538 ameloblastoma patients; the majority were of the primary type. Of the 538 ameloblastoma patients, 294 were male, 244 were female with a male to female ratio of 1.2:1. The predilection age is 20-30 years, which accounts for 40% of the total. In total, 461 cases were in the mandible and 77 were located in the maxilla. The cure rate of the primary type and the recurrence rate of the secondary type tumors were higher in the patients from the West China Hospital of Stomatology compared with those reported in the literature. In particular, a case with a long-term survival of 30 years is presented, which is considered to be relatively rare. The evolution of the clinical course has experienced three stages: Ameloblastoma (1978) followed by metastatic ameloblastoma (2000) and finally ameloblastic carcinoma (2008). To avoid recurrence, wide local excision with postoperative radiation therapy is required. While novel therapeutic regimens should also be considered as appropriate, including carbon ion therapy and Gamma Knife stereotactic radiosurgery. However, controlled studies with larger groups of patients are required to increase the accuracy of results.
    Oncology letters 08/2014; 8(2):914-920. DOI:10.3892/ol.2014.2230 · 0.99 Impact Factor
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    • "Numerous classifications[6–8] have been given and modified time and again for odontogenic epithelial malignancies. However, in 1984, Slootweg and Müller[6] emphasized that ameloblastoma may exhibit malignant features other than metastasis also and suggested the new classification system for malignant tumors with features of ameloblastoma, based on other characteristics of malignancy: "
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    ABSTRACT: Ameloblastic carcinoma (AC) is a rare malignant lesion with characteristic histologic features and clinical behavior that dictates a more aggressive surgical approach than that of a simple ameloblastoma. The tumor cells resemble the cells seen in ameloblastoma, but they show cytologic atypia. Direct extension of the tumor, lymph node involvement, and metastasis to various sites (frequently the lung) have been reported. Wide local excision is the treatment of choice. Regional lymph node dissection should be considered and performed selectively. Literature shows that radiotherapy and chemotherapy is of limited value for the treatment of AC. A case of AC of maxillary region is presented here. Clinical/histological characteristics of this tumor and current knowledge on the classification of odontogenic malignancies are also discussed.
    04/2012; 3(1):70-4. DOI:10.4103/0975-5950.102169
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    • ". Cisplatin, adriamycin, cyclophosphamide, paclitaxel, carboplatin have been used for chemotherapy, with best results achieved after paclitaxel and carboplatin therapy [23] [24]. In our patient, cyclophosphamide, adriamycin have little or no effect, while local shrinking of the primary tumor was noticed after carboplatin and etoposide treatment. "
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    ABSTRACT: Ameloblastic carcinoma is a rare cause of jaw tumors, especially in children. This rare, rapidly growing, malignant tumor of odontogenic origin affects predominantly the mandible and maxilla. Hypercellularity, lack of differentiation, high mitotic index, vascular and neural invasion are its main histological features. Local destruction and distant metastases to the lungs, bones, liver and brain are common in ameloblastic carcinoma. Prognosis is poor, due to its low sensitivity to chemo- and radiotherapy. We report the case of an 8-year-old girl with ameloblastic carcinoma of the left mandible and extensive right pleuro-pulmonary and bone marrow metastases. Biopsies made from the mandibular tumor and lung tumor tissue obtained by bronchoscopy, showed the same histological features, that of ameloblastic carcinoma. Diagnostic and treatment challenges are shown in this uncommon pediatric solid tumor of the jaw. Carboplatin and etoposide treatment showed some therapeutic effect upon the primary tumor, but lung infiltrations were not influenced. Palliative treatment was initiated. Early detection of ameloblastic carcinoma, before massive distant metastases develop would be an option for long-term survival, which can be achieved with radical surgery followed by radiotherapy.
    Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie 01/2012; 53(1):179-83. · 0.72 Impact Factor
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