Ameloblastic fibrosarcoma or odontogenic carcinosarcoma: a matter of classification?

Kunkel, Martin; Ghalibafian, Maryam; Radner, H.; Reichert, Torsten E.; Fischer, Berthold; Wagner, Wilfried

doi:10.1016/j.oraloncology.2003.09.010

Cited by 35 publications

(26 citation statements)

References 10 publications

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“…Until now, only four cases of ameloblastic carcinosarcoma have been reported in the literature [5].It is a rare mixed malignant odontogenic neoplasm with the ameloblastic features seen in the epithelial as well as the fibroblastic component. In the literature, this malignancy has been seen to arise in pre existing lesions like the ameloblastoma, ameloblastic fibrosarcoma [20,21], and ameloblastic fibroma [5] or arise de novo [22,23]. This tumor may metastasize to the lungs and the regional lymph nodes [5], however, our case did not show any such findings despite thorough investigation.…”

Section: Discussionmentioning

confidence: 59%

Trends in Pediatric Ameloblastoma and its Management: A 15 year Indian Experience

Andrade¹,

Shetye²,

Mhatre³

2012

J. Maxillofac. Oral Surg.

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Purpose The purpose of this study is to put forth our 15 year experience with pediatric ameloblastoma in the Indian population. Materials and Method This retrospective study was carried out in the pediatric group of 18 years and below, presenting with and diagnosed for ameloblastoma, at our institution over the past 15 years. The required data was collected by reviewing patient's case notes, relevant radiographs, histopathological reports, and treatment charts. The incidence of pediatric ameloblastomas with respect to age, sex, site of occurrence, histopathologic type, the type of treatment instituted, and recurrence rate was noted. Results Of the total 165 pediatric tumors, ameloblastoma was the most common, 29 cases (17.5%). It occurred commonly in the age group of 12-18 years (mean age 14 years) with a marked male predilection. The most common site of occurrence was the posterior mandible. Majority were of the unicystic type. Two ameloblastomas which appeared as unilocular radiolucency were diagnosed as solid type. Twenty-eight were benign and one was a rare malignancy (Ameloblastic carcinosarcoma). Only two recurrences were noted over 15 years, of which one tumor interestingly recurred as a peripheral variety which responded well to local excision. Ameloblastomas were either enucleated with mechanical curettage or resected followed by primary reconstruction with either a reconstruction plate or free fibula flap. Conclusion We conclude that ameloblastomas are not uncommon in Indian pediatric population. Unilocular, unicystic ameloblastomas in the pediatric age group can be treated conservatively owing to their growth potential. Emphasis must be given to a long-term regular follow-up, conserving a more radical approach in case of a recurrence. However, Unilocular appearing ameloblastomas may be of the solid type which needs to be borne in mind as it not only alters the treatment modality but also emphasizes the importance of pre-operative incisional biopsy. Solid and unicystic aggressive ameloblastomas must be treated radically. Primary reconstruction with the free fibula flap is a viable option.

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Section: Discussionmentioning

confidence: 59%

Trends in Pediatric Ameloblastoma and its Management: A 15 year Indian Experience

Andrade¹,

Shetye²,

Mhatre³

2012

J. Maxillofac. Oral Surg.

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“…Immunohistochemical studies may facilitate differentiation of this lesion because p53, Bcl-2, vimentin, and Ki-67 have been shown to be expressed within the sarcomatous mesenchyme of AFS. 8,10,[15][16][17] Ameloblastoma consists of benign ameloblastomatous epithelium embedded within a paucicellular stroma. In ameloblastoma, AF, and AFS, the benign ameloblastomatous epithelium showed positive immunoreactivity for broad-spectrum keratin (AE1/ AE3) while maintaining negativity for p53.…”

Section: Discussionmentioning

confidence: 99%

Ameloblastic Fibrosarcoma: Report of a Case, Study of Immunophenotype, and Comprehensive Review of the Literature

Lai

Blanas

Higgins

et al. 2012

Journal of Oral and Maxillofacial Surgery

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“…Immunohistochemical studies may facilitate diagnosis of these lesions, given that Ki-67, PCNA and p53 were found expressed at higher levels within the sarcomatous component of the AFS, whereas they are absent or expressed at lower levels in AF (5,12,62,69,79,89,101,113,123). Results obtained from several papers (4,5,69,79,82,88,89,113) revealed that Ki-67 was overexpressed (highly diffuse positivity) in the malignant mesenchymal portion of AFS, compared with AF.…”

Section: Discussionmentioning

confidence: 99%

“…Epithelial proliferation in AFS may represent an atavistic behavior of the epithelium in front of a dense neoplastic stroma. The presence of differences in proliferative potential between epithelial and mesenchymal AFS components is relevant for the differentiation of AFS from odontogenic carcinosarcoma, in which the epithelial and mesenchymal components are similarly proliferative and anaplastic (101,121,122).…”

Section: Discussionmentioning

confidence: 99%

Ameloblastic Fibrosarcoma: A Case Report and Literature Review

et al. 2017

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Here is described a case of ameloblastic fibrosarcoma (AFS) affecting the posterior mandible of a woman who was treated surgically and recovered without signs of recurrence or metastasis after 12 years of follow-up. Tumor sections were immunostained for cell cycle, epithelial and mesenchymal markers. Immunohistochemical analysis evidenced high Ki-67 positivity in stromal cells (mean of 20.9 cells/High power field). Epithelial cells displayed strong positivity for p53, p63 and cytokeratin 19. In addition to the case report, a systematic review of current knowledge is presented on the AFS's clinical-demographic features and prognostic factors. Based on the review, 88/99 cases were diagnosed as AFS, 9/99 as ameloblastic fibro-odontosarcoma and 2/99 as ameloblastic fibrodentinosarcoma. All these lesions displayed very similar clinical-demographic and prognostic features. Moreover, the review provided evidence that first treatment, regional metastasis, distant metastasis and local recurrence were significant prognostic values for malignant odontogenic mesenchymal lesions. Based on the findings, segregation among ameloblastic fibrosarcoma, ameloblastic fibrodentinosarcoma and ameloblastic fibro-odontosarcoma seems illogical, considering all these lesions have similar predilections and outcomes.

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Ameloblastic fibrosarcoma or odontogenic carcinosarcoma: a matter of classification?

Cited by 35 publications

References 10 publications

Trends in Pediatric Ameloblastoma and its Management: A 15 year Indian Experience

Trends in Pediatric Ameloblastoma and its Management: A 15 year Indian Experience

Ameloblastic Fibrosarcoma: Report of a Case, Study of Immunophenotype, and Comprehensive Review of the Literature

Ameloblastic Fibrosarcoma: A Case Report and Literature Review

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