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Case Reports
. 2015 Jul 1:16:415-9.
doi: 10.12659/AJCR.893918.

Ameloblastic Carcinoma

Dakshika Abeydeera Gunaratne  1 , Hedley G Coleman  2 , Lydia Lim  3 , Gary J Morgan  4
Affiliations
Case Reports

Ameloblastic Carcinoma

Dakshika Abeydeera Gunaratne et al. Am J Case Rep. .

Abstract

Background: Ameloblastic carcinoma secondary type is an extremely rare and aggressive odontogenic neoplasm that exhibits histological features of malignancy in primary and metastatic sites. It arises through carcinomatous de-differentiation of a pre-existing ameloblastoma or odontogenic cyst, typically following repeated treatments and recurrences of the benign precursor neoplasm. Identification of an ameloblastic carcinoma, secondary type presenting with histologic features of malignant transformation from an earlier untreated benign lesion remains a rarity. Herein, we report 1 such case.

Case report: A 66-year-old man was referred for management of a newly diagnosed ameloblastic carcinoma. He underwent radical surgical intervention comprising hemimandibulectomy, supraomohyoid neck dissection, and free-flap reconstruction. Final histologic analysis demonstrated features suggestive of carcinomatous de-differentiation for a consensus diagnosis of ameloblastic carcinoma, secondary type (de-differentiated) intraosseous.

Conclusions: Ameloblastic carcinoma, secondary type represents a rare and challenging histologic diagnosis. Radical surgical resection with adequate hard and soft tissue margins is essential for curative management of localized disease.

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Figures

Figure 1.
Figure 1.
Panoramic radiograph demonstrating a large, scalloped, well-defined, lucent lesion of the right mandible (arrows) in (A) January 2013 and (B) June 2012.
Figure 2.
Figure 2.
(A) Ameloblastoma with tumor cells exhibiting a plexiform growth pattern. (B) Ameloblastic tumour cells exhibiting characteristic reverse nuclear polarization and subnuclear vacuolation of the cytoplasm.
Figure 3.
Figure 3.
(A) Ameloblastic carcinoma with area of necrosis. (B) Ameloblastic carcinoma with tumor cells exhibiting crowding, nuclear pleomorphism, and mitotic activity.
Figure 4.
Figure 4.
Post-operative panoramic radiograph (June 2014) demonstrating an absent right mandible lateral to tooth 45 and no evidence of recurrent pathology adjacent to margins of resection.
See this image and copyright information in PMC

References

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