Ameloblastic Carcinoma of Mandible: Facts and Dilemmas

Abstract

Ameloblastic carcinoma is a rare malignant odontogenic tumor and is considered as the malignant counterpart of ameloblastoma with features of both benign and malignant histology. It may arise de novo or from a long-standing ameloblastoma and is locally aggressive with a propensity for metastasis. With limited documentation, little is known about its pathobiogenesis, with no universal guidelines for management. For clinicians, differentiating ameloblastic carcinoma from ameloblastoma and malignant ameloblastoma in a patient presenting with a suspicious jaw tumor is a challenge due to overlapping clinical features, inconclusive cytology/biopsy reports, different management approaches and inadequate follow-up. Proper knowledge of the disease entity and a high index of suspicion are essential. Here we elaborate the dilemmas in diagnosis and management of ameloblastic carcinoma through presentation of a representative case in a 56-year-old man presenting with a tumor in the mandible.

Mandibular ameloblastic carcinoma: case report and literature review

“…According to retrospective study of radiotherapy alone for recurrence (old surgery) and adjuvant radiotherapy after surgery [10] in 2016, radiotherapy offered the potential for disease control when exeresis margins were affected or when recurrence was noted. In other studies [6][7][8][9][10][11], this approach was reportedly ineffective. In our case, radiotherapy seemed to have stabilized the course of the disease, as seen on the last scan.…”

“…It is a malignant epithelial tumor that retains the characteristics of ameloblastic differentiation but also shows cytological characteristics of malignancy [3]. For diagnosis, most studies use immunohistochemical analysis of Ki67-a frequently elevated marker in ameloblastic carcinoma-which is an index of tumor proliferation [4][5][6][7]. This is an additional aid for the differential diagnosis of ameloblastomas.…”

“…However, decreased hearing acuity seemed to be a complication of radiation therapy and not tumor progression given the absence of radiological evolution of the tumor. The tumor evolves via either a rapid and aggressive local extension or a distant metastatic lesion, particularly pulmonary, appearing in the 4th to 12th month after the surgery [6]. The bone, liver, and brain are other metastatic sites.…”

Induction of Anti-agrin Antibodies Causes Myasthenia Gravis in Mice

“…Blood was collected via orbital sinus and incubated for 24 hr at 4°C, and centrifuged at 3000 rpm for 15 min. The supernatant was designated as serum and subjected to ELISA (enzyme-linked immunosorbent assay) as described previously (Dutta et al, 2014). Briefly, plates (Neobioscience) were coated at 4°C overnight with 100 μl of 10 μg/ml N-agrin or M-agrin in the coating buffer provided by the manufacturer (same below).…”

Addition of Diffusion-Weighted Imaging to Dynamic Contrast Enhanced MRI: can it help differentiate benign from malignant jaw lesions?

“…Assessing the biological behavior among the mandible and maxilla lesions is the rst step for clinical diagnosis and management. (8) Previous studies involving the roles of functional MRI, such as diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) MRI already have a wild application (7,9,10) , such as the brain, prostate, and breast, and head and neck (11)(12)(13) .…”