Primary ameloblastic carcinoma of the maxilla: A case report and literature review

Abstract

Ameloblastic carcinoma (AC) is a rare malignant odontogenic neoplasm that tends to occur in the mandible rather than in the maxilla. This malignancy is classified as a tumor that combines the morphological features of ameloblastoma and carcinoma, regardless of the presence or absence of metastasis. In addition, AC has been classified into two types, primary and secondary. The former develops de novo and the latter develops by malignant transformation of a pre-existing benign ameloblastoma. The present study describes the case of a 22-year-old patient with primary AC of the maxilla. A review of the literature focusing on the clinical details, treatment results and histopathological and phenotypic information available for ameloblastic carcinoma of the maxilla from a 60-year period was also performed. As a result, it was found that primary AC is dominant in the maxilla and does not exhibit an aggressive phenotype compared with secondary AC. In addition, the presence of recurrence was found to correlate with mortality, indicating that early, aggressive and complete removal of the tumor is the best treatment for survival.

Ameloblastic carcinoma of the maxilla: A rare case presentation and a review of new cases

“…In the present study, we assessed 17 newly reported cases of maxillary AC from 2009 to 2017 (see Table 1). [2,6,[8][9][10][11][12][13] The age ranges from 21 to 77 years (mean age: 57.1 years) and the male to female ratio was 7.5:1, which was consistent with the Kruse et al report. [3] Most of the lesions (88.2%) similar to the present case and to previously reported cases occurred in the posterior portion of the maxilla.…”

“…Cortical bone perforation, soft tissue invasion and nasal cavity involvement have been documented in previously reported cases. [7,9,12] Microscopically, AC often retains some histopathologic aspects of ameloblastoma such as inverse nuclear polarization and peripheral palisading in tumoral islands, demonstrating plexiform and follicular patterns, combined with histologic features of malignancy like hyperchromatism, pleomorphism, atypical mitoses, vascular and neural invasion and tissue necrosis. Spindle cell and clear cell-rich variants, and also a few cases with squamous differentiation have been reported.…”

“…Granular cell change and extensive clear cell component have been proposed as histologic prognostic indicators of AC. [10,12] With regard to aggressive behavior of AC and the spongy architecture of maxillary bone, the treatment of choice is complete surgical resection with 2 cm to 3 cm bony margins. [8,10,14] Despite partial resection and curettage, this approach reduces the recurrence rate by 15%.…”

Spindle cell variant of ameloblastic carcinoma: a case report and literature review

“…1,16,17 Metastatic lesions were detected in 22% of conventional ameloblastic carcinomas, except in the spindle cell variant. 15 Uzawa et al 18 reported that the recurrence rate of ameloblastic carcinoma was 38.4%. It has been reported that the period of recurrence and distant metastasis of ameloblastic carcinoma is longer than that of the head and neck squamous cell carcinomas.…”

“…It has been reported that the period of recurrence and distant metastasis of ameloblastic carcinoma is longer than that of the head and neck squamous cell carcinomas. 18 The average recurrence period from primary treatment was 47.5 months. The difference in mean ages for the two lesions suggests that more genomic changes are required to develop spindle cell variant of ameloblastic carcinoma compared with ordinary ameloblastic carcinoma.…”