Ameloblastic carcinoma of the maxilla: A case report

Abstract

Abstract. This study aims to present the clinical features and treatment of a case of maxillary ameloblastic carcinoma. Ameloblastic carcinoma is a rare malignant odontogenic carcinoma that has metastatic potential. Due to its rare incidence, there are few studies focusing on its radiological characteristics. When ameloblastic carcinoma demonstrates an aggressive appearance, it may be diagnosed as a malignant tumor; however, in cases showing a non-aggressive appearance, it is difficult to distinguish ameloblastic carcinoma from ameloblastoma. We report a case of ameloblastic carcinoma of the maxilla in a 59-year-old male patient, including the clinical signs, radiological images and pathological features. A partial area was surgically excised under local anesthesia and the material was sent to the Laboratory of Oral Pathology. The histological sections revealed a fragmented odontogenic tumor of epithelial origin, consisting of solid parenchyma and also revealed basal cells resembling ameloblasts, occasionally arranged in palisades. Certain parts of the architecture resembled that of an ameloblastoma; however, the cytology of other areas confirmed the diagnosis of ameloblastic carcinoma of the maxilla. The patient was scheduled for definitive surgery, including a right maxillectomy and radiotherapy. The patient was followed up every 3 months. After 2 years follow-up, there were no clinical or radiological signs of recurrence.

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.…”

“…The presence of local recurrence, lymph node and distant metastasis correlated with mortality. [10,17] In conclusion, AC of the maxilla is rare and predominantly occurs in the posterior area. It is most common in males and in the sixth decade of life.…”

“…[3,7] Radiotherapy alone for patients with advanced local or metastatic AC or who are not surgical candidate seems appropriate. [7,10] Owing to the small number of cases, elective radical neck dissection is still under review but radical neck dissection for tumors with evidence of positive cervical lymph nodes is recommended. [8,15] To date, few chemotherapy reports for local control are also available that revealed no significant advantages for AC patients.…”

“…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%.…”

“…[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%. [7,9] The effec-tiveness of adjuvant radiotherapy is debatable.…”