Metastatic ameloblastoma to a cervical lymph node: a case report and review of literature

Abstract

Case presentation A 54-year-old man, who 3 years prior had undergone successful surgical treatment of a left mandibular ameloblastoma, presented with a left submandibular swelling. Radiology confirmed a heterogenous solid nodule close to the previous mandibular resection site and the soft tissue nodule was resected. Histology revealed a lymph node containing a deposit of tumour with features typical of ameloblastoma. These included anastomosing strands of cells, peripheral palisading with reverse nuclear polarity and a dense fibrotic stroma. A further radical left neck dissection had 21 lymph nodes, none of which contained metastatic tumour. Discussion Ameloblastoma is a rare benign odontogenic tumour with locally aggressive behaviour and a high recurrence rate. Despite its benign histological appearance, ameloblastoma has the ability to metastasise, which occurs in less than 1% of cases. Most metastatic deposits are seen in the lung with few reported cases of lymph node metastases. Due to the rarity of cases, treatment of ameloblastoma with metastases to lymph nodes is controversial. Some recommend radical neck dissection, while others have proposed simple excision with close follow up in cases with a single node metastasis.