Ameloblastic carcinoma: case report and literature review.

Faculty of Dentistry, Laval University, Cité universitaire, Ste-Foy, Quebec.
Journal (Canadian Dental Association) (Impact Factor: 0.62). 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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    ABSTRACT: Ameloblastoma is a true odontogenic tumor that is most frequently found in clinical practice. Osseous resection with clear margins is the recommended treatment followed by bone reconstruction, such as a vascularized graft. The use of osseointegrated dental implants for rehabilitation is advisable, as it allows the recovery of the masticatory function. This case report includes 1 subject, a patient who presented with a large ameloblastoma treated by resection, a microvascular iliac graft, and dental implants. After 6 months of regular control, the patient exhibited perfect healing of both the soft tissues and bone graft. At the time of this report, the patient had undergone 36 months of clinical and radiographic follow-up and had not exhibited any sign of osseous loss, implant mobility, or tumor recurrence. The outcome of this case indicates that a microvascular graft and subsequent dental implantation is a good treatment plan that aids in a quick functional rehabilitation in ameloblastoma patients.
    Implant dentistry 10/2013; · 1.51 Impact Factor
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    ABSTRACT: Ameloblastoma is a common and easily diagnosed odontogenic tumor. When present with histologic atypia is crucial because transformation to ameloblastic carcinoma is potentially life-threatening. Ameloblastic carcinoma, the malignant counterpart of the ameloblastoma, a rare entity, is characterized histologically by malignant epithelium in the primary, recurrent, or metastatic deposit. It has a predilection for mandible and commonly metastasizing to the regional lymph nodes or lung. Most ameloblastic carcinomas according to literature reviewed, arise de novo, with few cases of malignant transformation of an ameloblastoma. In this paper we present three cases of ameloblastoma, of which one was ameloblastic carcinoma when diagnosed finally. Our aim is to substantiate the diagnostic challenge of this rare entity for both surgeons and pathologists. Introduction In 1972, the WHO included the malignant ameloblastoma with odontogenic Primary carcinoma of jaw bones is a carcinomas in its classification. The classification rare entity and the origins are different, including system by the World Health Organization defines not only odontogenic origin, but also entrapped malignant amelob lastoma as an ameloblastoma, salivary gland epithelium. Ameloblastic which has metastasized but exhibits the well-carcinomas may arise de novo or in preexisting differentiated morphologic features of a typical ameloblastoma or odontogenic cyst. Several ameloblastoma in both the primary and definitions have been specified for ameloblastic metastatic sites. Whereas, ameloblastic carcinoma including a well-differentiated carcinoma is the pathologic designation ameloblastoma with histo-logically malignant describing an ameloblastoma with areas of 1 6
    Oral and Maxillofacial Pathology. 01/2013; 4(1):339-345.
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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. · 0.24 Impact Factor


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