Cytopathologic features of secondary peripheral ameloblastic carcinoma: A case report

Abstract

Peripheral ameloblastic carcinoma is an extremely rare odontogenic tumor derived from the remnants of dental lamina and/or mucosal epithelium of the oral mucosa. We present a case of secondary peripheral ameloblastic carcinoma of the mandibular gingiva. The patient was a 71-year-old man with gingival swelling and persistent bleeding. Exfoliative cytology revealed cohesive clusters composed of basaloid cells with nuclear atypia and various forms of keratinized cells of dysplastic squamous appearance. Some cell groups had a peripheral palisade. Histology of the biopsy and surgically removed specimens revealed characteristic features resembling squamous cell carcinoma, basal cell carcinoma, and benign follicles of ameloblastoma. These neoplastic structures, as well as proliferation and elongation of the mucosal epithelium, comprised an extensive network. The varied cytopathologic findings may be related to proliferation and transformation of basal cells of the mucosal epithelium toward ameloblastic carcinoma and variable squamous differentiation.

Fine-needle aspiration biopsy of ameloblastic carcinoma of the mandible: a case report

“…There are only two cases of ameloblastic carcinoma diagnosed by FNAB in the literature (15,19), which have the same cytological features of the present case. Sharma et al (20) reported a case of malignant ameloblastoma that had malignant features, as atypical mitosis and vascular invasion, only at histology, showing that the cytological diagnosis of malignancy can be difficult.…”

“…The patient of this case presented a painless swelling in the right mandible angle, the most common sign and site of ameloblastic carcinoma. Her age was different from most cases described, but there are cases of ameloblastic carcinoma in patients over 70 years of age (15).…”

“…The term ameloblastic carcinoma was introduced by Shafer in 1983 (14) and is an extremely rare odontogenic tumor (15,16). The incidence of malignancy has been estimated in 1% of the cases.…”

Malignant peripheral ameloblastoma arising from the gingiva: A case report

“…[5] Ameloblastic carcinomas arising from peripheral ameloblastomas are exceedingly rare, with only approximately eleven cases of peripheral ameloblastic carcinoma having been reported to date, including one case of an initially benign appearing peripheral ameloblastoma recurring as ameloblastic carcinoma. [4,[6][7][8][9][10] Although there have been no prior studies demonstrating the relationship between non-Hodgkin lymphoma or radiation and the development of peripheral ameloblastoma, a retrospective study evaluating 322 non-Hodgkin lymphoma cases found a significantly increased risk for head and neck cancers among patients receiving radiation therapy for early-stage non-Hodgkin lymphoma. [11] Peripheral ameloblastomas typically manifest as slowgrowing, firm, painless masses, which can be sessile or pedunculated with a smooth, granular, or warty surface.…”

Peripheral ameloblastoma of gingiva with cytokeratin 19 analysis

“…Most commonly, recurrence is attributed to incomplete removal. Long-term follow-up is necessary, as cases of benign PA have been reported to recur and present as ameloblastic carcinoma 17 18…”