Abstract
The controversy of surgical seeding or metastasis of a recurrent ameloblastoma is discussed in this paper, where we present a case with a history of 28 years since primary diagnosis including several tumor removals and reconstructive events. 23 years after primary diagnosis, we removed a metastasis from the neck with similar histological features as the primary tumor and the following recurrences of the mandible. We argue that the removed tumor in the neck most possibly has its origin in surgical seeding of cells during earlier resection and reconstruction and not by common ways of metastasis. The seeding of tumor cells during tumor surgery and metastasis rate of malignant ameloblastoma is discussed and the literature in this area is reviewed in the paper.
Highlights
Ameloblastoma is an uncommon disease that represents 1% of all cysts and tumors diagnosed in the jaws [1,2]
In this study we report a case of a 67-year-old female with a recurrent ameloblastoma, which presented in the submandibular region
Metastasizing ameloblastoma is a rare tumor and it is renowned for appearing in approximately 2% to 5% of cases [12]
Summary
Ameloblastoma is an uncommon disease that represents 1% of all cysts and tumors diagnosed in the jaws [1,2]. These benign slow-growing aggressive neoplasms show a distressing tendency to exhibit locally aggressive behavior and local recurrence in 50% to 72% of cases [3,4]. The typical WHO description of a metastasizing (malignant) ameloblastoma is an ameloblastoma that metastasizes in spite of a benign histological appearance [9]. This must be clearly distinguished from the ameloblastic carcinoma (primary type) which is characterized by histological malignant features in both the primary and metastatic sites [7,10]. Recent literature portends that the incidence of metastasizing (malignant) ameloblastoma has been overestimated while the incidence of ameloblastic carcinoma has been undervalued [11]
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