Ameoblastic carcinoma of mandible - A rare case report with review of literature

Abstract

Ameloblastic carcinoma is a rare malignant lesion with characteristic histologic features and behavior that dictates more aggressive surgical approach than that of a simple ameloblastoma. However, reliable evidence of its biologic activity is currently unavailable due to the scarcity of well-documented cases. It occurs primarily in the mandible in a wide range of age groups; no sex or race predilection has been noted. It may present as a cystic lesion with benign clinical features or as a large tissue mass with ulceration, significant bone resorption and tooth mobility. Because the lesion is usually found unexpectedly after an incisional biopsy or the removal of a cyst, a guide to differential diagnosis is not usually useful. The identifying features of ameloblastic carcinoma must be known and recognized by dental practitioners. The tumour 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 tumour, lymph node involvement and metastasis to various sites (frequently the lung) have been reported. We present a case of ameloblastic carcinoma of the mandible with a clinical course of typical aggressiveness and extensive local destruction in a 27 year old male patient.

Ameloblastic carcinoma of mandible: Report of intriguing presentation

“…11,14 Male predominance (male:female = 1.4:1) has been noted. 5 The present case was unique in the proposition that it presented with a deeply fissured ulcer-like appearance with no obvious swelling or mass, which is rarely the presentation noted in literature. 14 However, what sets it apart are the features of rapidly emergent swelling, cortex perforation, pain and paresthesia.…”

“…[1][2][3] This aggressive entity although largely benign can permeate into bone and soft tissue but it rarely metastasizes. [4][5][6] This is corroborated by the fact that although more than 3,600 cases of ameloblastoma have been comprehensively studied, only about 60 cases of ameloblastic carcinomas have been reported, thus evincing their inadequately understood malignant features. [4][5][6] This is corroborated by the fact that although more than 3,600 cases of ameloblastoma have been comprehensively studied, only about 60 cases of ameloblastic carcinomas have been reported, thus evincing their inadequately understood malignant features.…”

“…1 The aspect of malignancy in ameloblastoma has been widely debated, but two rare malignant variants -the ameloblastic carcinoma and malignant ameloblastoma (prevalence ratio of 2:1) have been identified. [4][5][6] This is corroborated by the fact that although more than 3,600 cases of ameloblastoma have been comprehensively studied, only about 60 cases of ameloblastic carcinomas have been reported, thus evincing their inadequately understood malignant features. 7 Ameloblastic carcinoma is a belligerent tumor with bleak prognosis.…”

Acanthomatous ameloblastoma of mandible crossing the midline: A rare case report

“…Perforation of the cortical plate, extension into surrounding soft tissue, numerous recurrent lesions and metastasis, usually to cervical lymph nodes, can be associated with ameloblastic carcinomas and hence it should be considered as the differential diagnosis. [12] …”

Ameloblastic carcinoma of maxilla

“…It is a consensus that any ameloblastoma that metastasizes is malignant, even if the tumor shows benign histological features. Malignancies associated with ameloblastoma have been designated by a variety of terms,[23] including malignant ameloblastoma, ameloblastic carcinoma (AC), metastatic ameloblastoma, and primary intra-alveolar epidermoid carcinoma (PIOC). Of these, two have frequently been used interchangeably, and the difference between malignant ameloblastoma and AC should be known.…”