Ameloblastic carcinoma of the maxilla: A case report and an updated review of the literature

Abstract

Ameloblastic carcinoma (AC) is an uncommon malignant odontogenic tumor that can be difficult to differentiate from ameloblastoma and can arise directly as an undifferentiated lesion or from a pre-existing benign lesion. The current study presents a novel case of primary maxillary AC and review the literature on AC of the maxilla. The review of the literature indicates that secondary tumors and posterior localization are associated with a higher tendency for recurrence and, often, multiple recurrences. Surgical therapy, eventually followed by radiotherapy, is the treatment modality most frequently applied, while the role of chemotherapy remains unclear. Several new cases of maxillary AC have been recently described in literature, making this pathology more frequent than previously considered; this is perhaps an indication of an increased diagnostic sensibility, rather than a real increase in the incidence of the disease itself.

Three-Dimensional Printing Model as a Tool to Assist in Surgery for Large Mandibular Tumour: a Case Report

“…General treatment for these tumours is conservative enucleation or partial mandibulectomy. In cases of some tumours, inadequate surgical removal at the time of initial treatment is one of the risk factors recurrence [ 1 , 2 ] or malignant transformation [ 3 ]. Therefore these tumours must be completely enucleated or resected.…”

Ameloblastic carcinoma with metastasis to the parotid gland

“…4,6 The differential would also include a low grade adenocarcinoma of the salivary gland, which would show cuboidal and spindled cells with oval nuclei containing finely reported over a broad range of ages, with a slight male predominance. 3,8,11 Ameloblastic carcinomas show aggressive behavior with local invasion. 3,8,11 Ameloblastic carcinomas show aggressive behavior with local invasion.…”

“…4,6 The differential would also include a low grade adenocarcinoma of the salivary gland, which would show cuboidal and spindled cells with oval nuclei containing finely stromal MMP-9, and SOX2 have been suggested to help differentiate ameloblastic carcinoma from ameloblastoma. 8,9 A Ki-67 index of two mitoses per high power field has been suggested as a cutoff for ameloblastic carcinoma. 10 Ameloblastomas and ameloblastic carcinomas are most common in the posterior mandible.…”

“…1,3,11 The clinical presentation typically includes painful swelling or a rapidly growing mass, which appears cystic on imaging and can be associated with ulceration and tooth mobility. 3,8,11 Ameloblastic carcinomas show aggressive behavior with local invasion. Metastases to lung and regional lymph nodes are common with reports of metastases to liver, bone, brain, kidney, small intestine, and myocardium.…”

“…Metastases to lung and regional lymph nodes are common with reports of metastases to liver, bone, brain, kidney, small intestine, and myocardium. 1,8,11 The preferred treatment is resection, often with adjuvant radiation. 1,12 The overall prognosis is unclear due to rarity of disease and limited followup in the literature; however, long-term follow-up is recommended as recurrence has been reported later than ten years following initial diagnosis.…”