Malignant odontogenic tumors: an overview

Abstract

Malignant odontogenic tumors are rare lesions. Only through the gradual accumulation of single cases can one obtain some information about their histomorphology, clinical presentation, and behavior. Just as their benign counterparts, they are of epithelial, mesenchymal, or mixed nature. Features of the several entities currently recognized are described in this overview.

Malignant Odontogenic Tumors: A 22‐Year Experience

“…The malignant forms of ameloblastoma have been classified into two subtypes according to clinical behavior and histological features: the malignant ameloblastoma or metastasizing ameloblastoma, in which distant metastatic lesions are present yet histologically resemble the primary benign‐appearing ameloblastoma, 3 and the ameloblastic carcinoma, in which the primary lesion shows dedifferentiation and cytological atypia as compared with a benign ameloblastoma 4 . Therefore, ameloblastic carcinomas are classified as tumors that combine morphological features of ameloblastoma and carcinoma, regardless of the presence or absence of metastasis.…”

“…Malignant ameloblastoma is a diagnosis that is usually made in retrospect, subsequent to metastasis of the lesion 3 . This tumor typically occurs in the mandible.…”

“…Metastases are typically found in the lung (88%) and the lymph nodes (27%) 5 . Distant metastasis to bone, brain, kidney, small intestine, and liver has been reported, refuting the idea that lung metastases simply represent an outgrowth of aspirated tumor fragments 3 …”

Ameloblastic carcinoma of the mandible with metastasis to the skull and lung: advanced imaging appearance including computed tomography, magnetic resonance imaging and positron emission tomography computed tomography

“…According to the Slootweg and Mü ller 6 classification system, odontogenic carcinomas include five subclassifications: malignant (metastasizing) ameloblastoma, ameloblastic carcinoma, primary intraosseous squamous cell carcinoma, clear cell odontogenic carcinoma, malignant epithelial odontogenic ghost cell tumour. The World Health Organization defines ameloblastoma as a locally aggressive benign odontogenic tumour, and metastasizing (malignant) ameloblastoma and primary and secondary ameloblastic carcinoma as malignant tumours.…”

Ameloblastic fibro-odontosarcoma of the mandible: imaging findings

“…Those extremely rare lesions that combine carcinomatous and sarcomatous elements, but are recognizable as odontogenic through their epithelial component resembling ameloblastic carcinomas, have been called odontogenic carcinosarcoma or odontogenic carcinoma with sarcomatous proliferation. 11,12 To date only 15 cases of AFDS/ AFOS have been reported in the English-language literature. 10,13 To our knowledge, CT findings of AFOS have not been described in the radiology literature.…”