Published online Feb 16, 2014. doi: 10.12998/wjcc.v2.i2.48
Revised: November 30, 2013
Accepted: January 7, 2014
Published online: February 16, 2014
Ameloblastic carcinoma is a rare odontogenic tumor exhibiting histological evidence of malignancy in the primary or recurrent tumor. It is characterized by rapid, painful expansion of the jaw, unlike conventional ameloblastomas. The tumor most frequently involves the mandible. The expanding lesion causes perforation of the buccal and lingual plates of the jaw and invades the surrounding soft tissue. Rapidly growing large tumor mass may cause tooth mobility. A mandibular tumor involving the mental nerve leads to paresthesia of the nerve. A maxillary tumor can produce a fistula in the palate and paresthesia of the infraorbital nerve. Most ameloblastic carcinomas are presumed to have arisen de novo with a few cases of malignant transformation of ameloblastomas. Although rare, these lesions have been known to metastasize, mostly to the regional lymph nodes or lungs. A case of ameloblastic carcinoma in a 60-year-old man is reported here and its clinical, radiological and histological features are discussed.
Core tip: Clinically, ameloblastic carcinoma is more aggressive than most typical ameloblastomas, with extensive local destruction, perforation of the cortical plate, extension into surrounding soft tissues, numerous recurrent lesions and metastasis, usually to cervical lymph nodes. Histologically, the tumor cells resemble cells seen in ameloblastoma but show cytological atypia, cellular pleomorphism, nuclear hyperchromatism, mitoses and vascular and neural invasion. These identifying features of ameloblastic carcinoma must be known and recognized by dental practitioners. It is probable that ameloblastoma, like other tumors (such as carcinoid tumors and epithelial tumors of the ovary), shows a spectrum of histological and biological behavior, ranging from benignity at one end to frank malignancy at the other.