Case Of Ameloblastic Carcinoma Research Articles

Ameloblastic Carcinoma of the Mandible: a Rare Case Report

Ameloblastic carcinoma is characterized by rapid, painful expansion of the jaw, unlike conventional ameloblastoma. The tumor most frequently involves the mandible. The expanding lesion causes perforation of buccal and lingual plates of the jaw and invades the surrounding soft tissue. Rapidly growing large tumor mass may cause tooth mobility. Mandibular tumor involving mental nerve leads to the paresthesia of the nerve. Maxillary tumor can produce fistula in the palate and paresthesia of infraorbital nerve. Although rare, these lesions have been known to metastasize mostly to the regional lymph nodes or lungs. Because the lesion is usually found unexpectedly after an incisional biopsy or the removal of a cyst, a guide to the differential diagnosis is usually not useful. The tumor cells resemble the cells seen in ameloblastoma, but they show cytologic atypia. Moreover, they lack the characteristic arrangement seen in ameloblastoma. Direct extensions of the tumor, lymph node involvement have been reported. A case of ameloblastic carcinoma in a 60 year old man of typical aggressiveness and extensive local destruction is reported here and its clinical, radiographical and histological features are discussed.

Challenges in Diagnose and Management of Ameloblastic Carcinoma: A Report of Three Cases

Challenges in Diagnose and Management of Ameloblastic Carcinoma: A Report of Three Cases Ameloblastic carcinoma is a rare odontogenic carcinoma with challenges in diagnosis and management. Ameloblastic carcinoma is defined by histologic presentation, which combines histopathologic features of ameloblastoma and malignancy. Ameloblastic carcinoma has different clinical features in the maxilla and in the mandible. Two cases of ameloblastic carcinoma in mandible and one case in maxilla are presented. The first patient is a 44-year-old woman with painful swelling in right posterior side of mandible and cheek. The second patient is a 42-year-old man with a right maxillary swelling. And the third case is an 18-year-old woman with a large lesion in posterior of mandible. In all of the patients, the tumors were exited with significant safe margins. In the first patient the initial diagnosis was ameloblastoma recurrence but in all patients the final diagnosis was ameloblastic carcinoma. We showed that the survival key of patients is aggressive surgical intervention

15歳男子の下顎骨に生じた原発型エナメル上皮癌の1例

15歳男子の下顎骨に生じた原発型エナメル上皮癌の1例

Usefulness of 11C-methionine positron emission tomography for detecting intracranial ameloblastic carcinoma: A case report.

Ameloblastic carcinoma, secondary type, is an extremely rare odontogenic malignant tumor. The present study reports the case of a 58-year-old male with ameloblastic carcinoma that extended into the intracranial space close to the internal carotid artery. Surgical excision was performed, as headaches were being caused via compression by the mass. Small remnants of the tumor remained surrounding the internal carotid artery following surgical resection. Although the remnant tissue was not detected on magnetic resonance imaging or 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET), it was clearly visualized on 11C-methionine PET in the early post-operative follow-up period. No neurological deficits were exhibited during the follow-up period, and 11C-methionine PET was able to detect the remnant lesion distribution in the intracranial space. The current study presents a rare case of ameloblastic carcinoma that extended into the intracranial space. In addition, several diagnostic imaging tools were compared in order to determine the most suitable imaging modality. At present, the patient is continuing a therapeutic course of radiation and evident mass reduction has been observed. However, the therapeutic effects are currently under consideration. To the best of our knowledge, this is the first study on the effectiveness of using 11C-methionine PET for detecting ameloblastic carcinoma with intracranial extension.

Ameloblastic carcinoma: Report of a rare case

Ameloblastic carcinoma is a rare odontogenic tumor exhibiting histological evidence of malignancy in the primary or recurrent tumor. It is characterized by rapid, painful expansion of the jaw, unlike conventional ameloblastomas. The tumor most frequently involves the mandible. The expanding lesion causes perforation of the buccal and lingual plates of the jaw and invades the surrounding soft tissue. Rapidly growing large tumor mass may cause tooth mobility. A mandibular tumor involving the mental nerve leads to paresthesia of the nerve. A maxillary tumor can produce a fistula in the palate and paresthesia of the infraorbital nerve. Most ameloblastic carcinomas are presumed to have arisen de novo with a few cases of malignant transformation of ameloblastomas. Although rare, these lesions have been known to metastasize, mostly to the regional lymph nodes or lungs. A case of ameloblastic carcinoma in a 60-year-old man is reported here and its clinical, radiological and histological features are discussed.

Ameloblastic Carcinoma: A Rare Case Report and Review of Literature

Ameloblastic carcinoma is a rare, odontogenic, malignant tumor that has features of ameloblastoma in addition to cytologic atypia with or without metastasis. Very few cases have been mentioned in the review of literature regarding ameloblastic carcinomas. Here we present a case of ameloblastic carcinoma, which was an incidental finding, the investigations done, the surgical management, and the prognosis of a 28-year-old male patient.

Expression and mechanism of regulation of PP2A/Pr65 in ameloblastoma

ObjectiveThis study aimed to investigate the expression of PP2A/PR65 protein in ameloblastoma and the molecular mechanisms underlying the regulation of PP2A/PR65. The association between PP2A/PR65 and the clinicopathological characteristics of tumor specimens in ameloblastoma were to provide a theoretical basis for the diagnosis, therapy and prognosis of ameloblastoma. Study designStreptavidin–peroxidase (S–P) immunohistochemical staining was used to detect PP2A/Pr65 expression changes in a total of 68 cases of ameloblastoma, six ameloblastic carcinomas, 21 squamous cell carcinomas and seven normal oral mucosas. Western blot was used to analyze PP2A/PR65 protein expression in 15 cases of ameloblastoma and three cases of normal oral mucosa. ResultsOf the 68 cases analyzed, four cases were negative, 25 cases were weakly positive, 20 cases were moderately positive and 19 cases were strongly positive. In six cases of ameloblastic carcinoma, three cases were weak positive, one case was positive, two cases were strongly positive and none were negative. In 21 cases of squamous cell carcinomas, three cases were negative, 17 cases were weakly positive, one case was moderately positive and none were strongly positive. Western blot analysis showed that, PP2A/Pr65 protein expression was lower in ameloblastoma tissue compared with normal oral mucosa. ConclusionsReduced expression of PP2A/PR65 in ameloblastoma compared with normal oral mucosa indicates that PP2A/PR65 is involved in the occurrence and development of ameloblastoma.

Ameloblastic carcinoma: Report of two cases

Malignant odontogenic tumours are extremely rare in New Zealand. Two cases of ameloblastic carcinoma were diagnosed recently based on the histopathological features including features of epithelial malignancy with some infiltrating islands showing peripheral columnar differentiation towards pre-ameloblast like cells. Calretin staining was positive. Definitive evidence of ameloblastic differentiation must be demonstrated to rule out primary intraoral squamous cell carcinoma and metastasis from other sites. The clinical and histopathological features of the two cases will be discussed.

Ameloblastic carcinoma of maxilla

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.

Comparative immunohistochemical study of ameloblastoma and ameloblastic carcinoma

Ameloblastic carcinoma combines the histologic features of ameloblastoma with cytologic atypia, regardless of whether it has metastasized. Because of its rarity, there are few immunoprofile studies of ameloblastic carcinoma and few comparative studies of ameloblastic carcinoma and ameloblastoma. In this study, we compared the expression levels of cytokeratins (CKs), matrix metalloproteinases (MMPs), and Ki-67 between ameloblastoma and ameloblastic carcinoma, and assessed the usefulness of these markers for differentiating the tumors. We assessed CK7, CK14, CK18, CK19, MMP-2, MMP-9, and Ki-67 expression by immunohistochemistry in 10 cases of ameloblastoma and 7 cases of ameloblastic carcinoma and then compared expression patterns between the 2 groups. Immunostaining for CK14 and CK19 was diffuse and strongly positive in both tumor types, but staining for CK7 was focally positive in only 1 case of ameloblastoma and absent in all cases of ameloblastic carcinoma. However, there was a significant difference in CK18 expression between the 2 tumors (P = .000). Whereas 80% of ameloblastomas showed negative reactivity for CK18, most cases of ameloblastic carcinomas showed a moderate to strong intensity of immunostaining for CK18. Regarding the expression of MMPs, there were significant differences in parenchymal MMP-2 and stromal MMP-9 expression between the 2 tumors. Compared to ameloblastoma, ameloblastic carcinoma showed significantly strong expression of MMP-2 in parenchymal cells (P = .001) and MMP-9 in stromal cells (P = .013). However, there were no differences in MMP-2 expression of stromal cells and MMP-9 expression of parenchymal cells between ameloblastoma and ameloblastic carcinoma. The mean Ki-67 labeling index (LI) of ameloblastic carcinomas was 17.21%, which was significantly higher than that of ameloblastomas (3.57%; P = .002). The significant expression of CK18, parenchymal MMP-2, stromal MMP-9, and Ki-67 could provide useful markers for differentiating ameloblastic carcinoma from ameloblastoma.

Fine-needle aspiration biopsy of ameloblastic carcinoma of the mandible: a case report

The use of fine-needle aspiration biopsy (FNAB) in the diagnosis of odontogenic tumors seems to have attracted little attention. The presence of a firm preoperative diagnosis helps preventing suboptimal surgery, contributing to avoid recurrence of these tumors. A case of ameloblastic carcinoma of the mandible diagnosed by FNAB is presented in this report, illustrating its effectiveness for preoperative diagnosis of odontogenic tumors. A 74-year-old female presented with a painless swelling in the right mandibular angle. A panoramic radiograph revealed a radiolucent lesion in the body of the mandible. Cytological smears from FNAB in the area revealed basaloid cells with a palisade arrangement and presence of stellate-shaped cells. These cytological features lead to the diagnosis of ameloblastoma. However, when there are atypical cells and atypical mitoses, as in the present case, diagnosis of ameloblastic carcinoma may be established. The patient underwent chemotherapy, showing remission of the lesion after treatment. FNAB is a minimally invasive, safe, fast and inexpensive method for diagnosing benign and malignant ameloblastomas, which ensures that patients have a proper treatment without the need of performing an incisional biopsy, especially in neoplastic cases.

Poster Board Number: 19: Ameloblastic Carcinoma: An Underdiagnosed Entity?

Statement of the Problem: Ameloblastic carcinoma (AC) is a very rare odontogenic malignancy that demonstrates clinical, radiographic, and histologic findings identical to those of ameloblastoma. In comparison to the ameloblastoma, the ameloblastic carcinoma is a malignant counterpart that is very aggressive and often metastasizes. The suggested treatment modality for these two tumors differs significantly with AC possibly requiring radiation therapy and neck dissection. Materials and Methods: A retrospective chart review from 2008 to 2010 was performed on patients who had histologic diagnosis of ameloblastoma. The patients’ final pathology was evaluated and patients with a diagnosis of ameloblastic carcinoma were selected. 4 cases of ameloblastic carcinoma were diagnosed at New York University, Langone Medical Center. The patients’ charts were reviewed and the following variables evaluated; sex, age, location, signs and symptoms, treatment, recurrence, metastasis, pathology at biopsy, and pathology at final diagnosis. Methods of Data Analysis: The variables were analyzed and quantitative statistics applied.

Ameloblastic carcinoma: an analysis of 6 cases with review of the literature

The purpose of this study is to report 6 cases of ameloblastic carcinoma and to analyze all published cases regarding demographic features, clinical behavior, treatment, and prognosis. We reviewed our 6 cases of ameloblastic carcinoma and 98 cases previously reported in the English literature. Available follow-up data from 59 cases was analyzed. In the analysis of our cases, the average age of 6 patients was 61 years and there was a predilection for the maxilla and male. Five cases arose de novo, whereas 1 case was secondary type of ameloblastic carcinoma. Microscopically, our cases showed malignant cytologic features with some histologic features of ameloblastoma. Malignant cytologic features included nuclear pleomorphism, hyperchromatism, and high mitotic activity (33.3%). Necrosis and vascular invasion were also seen in 4 cases and 1 case, respectively. Immunostaining for cytokeratins 5, 14, and 18 was all positive and labeling index of Ki-67 was 13.91%. Two patients (33.3%) had a metastatic lesion in the regional lymph nodes without distant metastasis. In the analysis of the literature, the mean age was 49.2 years with a wide age range (7-91 years). The rate of occurrence was higher in males, and the most common site of occurrence was the mandible. The male-to-female ratio was 1.97:1 and the mandible-to-maxilla ratio was 1.71:1. Most cases (70%) involved the posterior portion of the jaw. The most common symptom was swelling, followed by pain, ulceration, paresthesia, and trismus. The recurrence rate in patients treated with surgical resection was 28.3%, whereas the rate in cases of conservative therapy was 92.3%. There was a significant correlation between treatment modality and recurrence (P = 0.000). Metastatic lesions were detected in 22% of patients during follow-up, and the lung was the most common area of distant metastasis. The 5- and 10-year survival rates were 72.9% and 56.8%, respectively. There was a significant decrease in the 5-year survival rate in patients with metastasis (21.4%; P = 0.0000). Metastasis from an ameloblastic carcinoma is significantly correlated with poor prognosis. Therefore, diagnosis at an early stage and close periodic screening for metastasis are necessary to improve patient prognosis.

Immunohistochemical characteristics of odontogenic carcinomas: their use in diagnosing and elucidating histogenesis

We investigated the immunohistochemical characteristics of 13 cases of odontogenic carcinoma, including 3 cases of ameloblastic carcinoma, 9 cases of primary intraosseous squamous cell carcinoma (PIOSCC), and 1 case of ghost cell odontogenic carcinoma (GCOC), to elucidate the origin and determine diagnostic markers of odontogenic carcinoma. Thirty cases of gingival squamous cell carcinoma (gSCC) were included for comparison. All ameloblastic carcinomas and GCOC cases, as well as 6 of 9 PIOSCC cases, exhibited immunoreactivity for CK19, whereas only 3 of 30 gSCC cases were positive for CK19. Two cases of ameloblastic carcinoma and only 1 case of PIOSCC expressed CD56; however, CD56 was not expressed in any gSCC cases. All odontogenic carcinoma cases except a single GCOC case were negative for calretinin. These findings indicate that immunoreactivity to CK19 is useful to identify odontogenic origin of the odontogenic carcinomas including PIOSCC, and it may also be useful for distinguishing PIOSCC from gSCC.

Ameloblastic carcinoma: Report of a case

Ameloblastic carcinoma is a rare epithelial odontogenic tumour of the jaws which exhibits cytological features of ameloblastoma and carcinoma. A case of ameloblastic carcinoma in a 52 year old male is reported. Clinical / histological characteristics of this tumour and current knowledge on the classification of odontogenic malignancies are discussed. The importance of including ameloblastic carcinoma in the differential diagnosis of persistent jaw swellings associated with toothache or mobility of teeth or failure of healing of extraction sockets is emphasized. Nigerian Journal of Surgical Research Vol. 7(1&2) 2005: 222-225

Ameloblastic carcinoma containing melanocyte and melanin pigment in the mandible: a case report and review of the literature

A case of ameloblastic carcinoma containing melanocyte and melanin in a 66-year-old male with swelling and an ulcerating firm mass in the left submandibular region is presented. The diagnosis was confirmed by biopsy. The current histopathological diagnosis and management are discussed.

Malignant odontogenic tumors: a 22-year experience.

Malignant odontogenic tumors are exceedingly rare and arise from odontogenic epithelial residues and odontogenic cysts in the jaw bones. Odontogenic malignancies have various origins. Some develop directly from the remnants of odontogenic epithelium left after completion of dental development; others may result from malignant transformation of a benign odontogenic cyst or ameloblastoma. These lesions are usually locally aggressive with radical surgery being the primary mode of treatment. Because of their rarity, much of the existing information about malignant odontogenic tumors with regard to their origin, clinicopathological features, biological behavior, and therapeutics is derived from case reports or small series. The study represents one of the largest series of malignant odontogenic tumors compiled in a single institution. Retrospective 22-year review from an Academic Medical Center. Twenty cases of reported malignant odontogenic tumors were diagnosed in the authors' institution between 1981 and 2002. All pathological slides were reviewed to reconfirm diagnosis. Malignancy was confirmed based on the following criteria: histological findings of infiltrative growth, atypical cytological features, and focal necrosis or clear evidence of distant metastatic spread. Patient age, race, sex, treatment and outcome were recorded on chart review. Of the twenty reported cases, only nine were actually found to be malignant tumors on re-evaluation. These consisted of four cases of malignant ameloblastomas, two cases of ameloblastic carcinoma, one case of malignant Pindborg tumor (calcifying epithelial odontogenic tumor), one case of odontogenic ghost cell carcinoma, and one case of squamous cell carcinoma arising in an odontogenic keratocyst. The racial demographics were six Caucasian patients, one African American patient, and two Asian patients; seven men and two women represented the gender distribution. Tumors of six cases were located in the mandible, and of three cases, in the maxilla. All cases were treated with radical surgical excision. Two patients died of their disease, three patients were alive and free of disease, and four patients were lost to follow-up. Malignant odontogenic tumors are rare. They require a multidisciplinary team to determine proper treatment. Long-term surveillance is mandatory and is accomplished by routine physical examinations, along with serial radiographic imaging.

Ameloblastic Carcinoma

This report is of the first case of ameloblastic carcinoma in a 35-year-old Thai man. Histologically, the lesion showed areas of typical ameloblastoma as well as areas of anaplastic transformation. The patient was treated by partial mandibulectomy followed by postoperative radiation therapy. There was no recurrence after the follow-up period of 1.5 years. The literature is reviewed with respect to the classification, clinical presentation, radiographic findings, histological findings, and treatment of this rare lesion.

Ameloblastic carcinoma of the maxilla: a report of 3 cases

Odontogenic carcinomas of the maxilla are classified as malignant ameloblastoma, ameloblastic carcinoma or primary intraosseous carcinoma. The term 'ameloblastic carcinoma' is used to describe those ameloblastomas in which there is histological evidence of malignancy in the primary, recurrent or metastatic tumour. Three cases of ameloblastic carcinoma with an unusual location in the maxilla are presented here. Histologically, the lesions were characterized by typical zones of ameloblastoma as well as zones with anaplastic transformation. The authors review the literature describing the clinical and histological presentation and the treatment of this rare tumour.

Immunohistochemical study on proliferating cell nuclear antigen expression in ameloblastomas.

The aim of this study is to evaluate the proliferating activity of ameloblastomas and its correlation to the biological behaviour according to each histological type. 38 cases of solid and unicystic ameloblastomas were reviewed including 1 case of ameloblastic carcinoma and 1 recurrent case. An anti-PCNA antibody, PC10(Dako), was applied for the detection of proliferating cell nuclear antigen (PCNA) in paraffin embedded tissue sections. Also 20 cases of dentigerous cysts were reviewed. In conclusion, we observed that there was no difference between the proliferating activities of the different histological types of solid ameloblastomas. Because 1 case of ameloblastic carcinoma and one recurrent case revealed remarkably high PCNA reactivity, we believe that PCNA would be useful in showing the differentiation between benign and malignant ameloblastomas. In unicystic ameloblastomas, plexiform intraluminal growth was considered to be an important feature in tumorous transformation of cystic epithelium.