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European Archives of... Oct 2017Ameloblastic carcinoma is a rare locally aggressive odontogenic neoplasm. These tumors are most commonly found to arise from mandible. Because of rarity, there is... (Review)
Review
Ameloblastic carcinoma is a rare locally aggressive odontogenic neoplasm. These tumors are most commonly found to arise from mandible. Because of rarity, there is limited information about the clinical behaviour of such patients. We intended to perform this review of published literature to assess the demographic profile, pattern of care and assess survival outcomes. Two authors independently searched PubMed, Google search, and Cochrane library for eligible studies from 1950 until July 1 2016 published in English language. Data of 199 patients were retrieved from 94 publications for statistical analysis. Median age of the entire cohort was 49 years (range 7-91 years). The analysis revealed that a clear twofold higher incidence in male with male-to-female ratio was 2.4:1 (140:57). Mandible was found to be the commonest tumor location in 66.7% (n = 132) cases followed by maxilla (31.8%) (n = 64). The present analysis revealed that median PFS of 57 months (95% CI 39-120 months) with 5- and 10-year PFS was found to be 47.88 and 29.48%, respectively. Median OS for the entire cohort which was 122 months (95% CI 96-153 months) with 2- and 5-year OS for the entire cohort was 87.16 and 69.08%, respectively. In univariate analysis, patients with an R0 resection were found to have a favourable survival. In addition, patients with localized disease and younger age were found to have a better survival. Adjuvant radiation did not confer any survival advantage. The present analysis revealed excellent outcome for patients treated with an R0 resection. Older patients with high-risk factor may benefit from adjuvant radiation. Role of chemotherapy needs to be evaluated.
Topics: Adult; Aged; Ameloblastoma; Antineoplastic Protocols; Carcinoma; Child; Combined Modality Therapy; Dissection; Female; Humans; Jaw Neoplasms; Male; Prognosis; Risk Adjustment; Survival Analysis
PubMed: 28600599
DOI: 10.1007/s00405-017-4631-7 -
Military Medicine May 2015Ameloblastic carcinoma is a rare and malignant odontogenic tumor. Approximately, 100 cases of ameloblastic carcinomas have been reported in the literature, with fewer... (Review)
Review
Ameloblastic carcinoma is a rare and malignant odontogenic tumor. Approximately, 100 cases of ameloblastic carcinomas have been reported in the literature, with fewer than 10 reported cases of an even more rare variant with spindle-cell differentiation. Although it is presumed that most ameloblastic carcinomas arise de novo, it also appears capable of proliferating as carcinoma ex ameloblastoma. Without a full past history, the exact origin of these tumors can be unclear. The exact classification becomes further questionable when both an intraosseous and peripheral tumor exists. This currently reported case has been present for at least 4 years before the patient presenting for care. However, without prior biopsy, the etiology and category of this ameloblastic carcinoma is speculative. Our case represents a histologically unequivocal case of ameloblastic carcinoma. Based on tumor morphology, questions still remain, as to whether it arose de novo, or as carcinoma ex ameloblastoma. The possibility of categorizing the current lesion as a spindle cell variant also exists because of the presence of a prominent population of malignant epithelial spindled cells arranged in fascicles. The authors believe that this ameloblastic carcinoma would best be subclassified as a rare spindle cell variant, based on the prominent spindle cell component.
Topics: Ameloblastoma; Carcinoma; Humans; Male; Mandibular Neoplasms; Middle Aged
PubMed: 25939122
DOI: 10.7205/MILMED-D-14-00509 -
The Journal of Craniofacial Surgery Nov 2011Ameloblastic carcinoma (AC) is a rare neoplasm of the maxillofacial district. It usually occurs in the posterior region of the jaw. In one third of cases, it occurs in... (Review)
Review
Ameloblastic carcinoma (AC) is a rare neoplasm of the maxillofacial district. It usually occurs in the posterior region of the jaw. In one third of cases, it occurs in the maxilla, usually in the posterior portion. From a review of international literature, we found 60 cases described. A 77-year-old patient presented to our division of maxillofacial surgery after the onset of a vegetans lesion of the maxilla. He had already been subjected to a first histologic examination that detected an AC. Surgery consisted of removal of a trapezoidal flap of the maxillary bone containing the mass. Histologic examination confirmed preoperative biopsy findings. Because of the low compliance, we did not plan for surgical reconstruction.Surgical resection is the treatment of choice for this kind of lesion, leaving at least a 2-cm free margin. Neoadjuvant radiotherapy may be useful for tumor debulking.
Topics: Aged; Ameloblastoma; Diagnosis, Differential; Humans; Male; Maxillary Neoplasms; Surgical Flaps; Tomography, X-Ray Computed
PubMed: 22134276
DOI: 10.1097/SCS.0b013e318231e49b -
Head & Neck Oncology Aug 2009The ameloblastic carcinoma is a rare malignant odontogenic tumor which rather occurs in the mandible than in the maxilla. Its rarity and in this context somewhat... (Review)
Review
BACKGROUND
The ameloblastic carcinoma is a rare malignant odontogenic tumor which rather occurs in the mandible than in the maxilla. Its rarity and in this context somewhat speculative histopathogenesis may account for diagnostic difficulties. Current classifications do not consider benign histopathological features at the primary and malignant features at the metastatic tumour site. Based on an evidence-based literature review, a recommendation for a novel classification is presented.
METHODS
An evidence-based literature review over the last 60 years regarding ameloblastic carcinoma of the maxilla was conducted.
RESULTS
An overall of 26 cases were found (mean age: 54.4 (583 years); male to female ratio: 2.7 to 1). In 54% the primary diagnosis was ameloblastic carcinoma, 34.6% revealed pulmonary metastases, however, only in one patient cervical lymph node metastasis could be found. Whereas two cases did not reveal malignant histopathology at the primary, they revealed malignant features at their metastatic sites. Nineteen of 26 patients (73,1%) were controlled during a median follow-up time of 54,3 months (6 to 156 months); 6 patients died of disease after a median time of 62,7 months (7 to 156 months) after initial diagnosis.
CONCLUSION
It is of utmost importance to be aware of that ameloblastomas may be capable to degenerate into a "malignant" disease with recurrence and metastasis. In addition to local long-term control, special attention should be paid to potential pulmonary involvement.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ameloblastoma; Child; Child, Preschool; Evidence-Based Medicine; Female; Humans; Male; Maxillary Neoplasms; Middle Aged; Neoplasm Recurrence, Local
PubMed: 19674470
DOI: 10.1186/1758-3284-1-31 -
Oncology Letters Aug 2014The diagnosis of ameloblastic carcinoma is often difficult and the optimal treatment methods remain controversial. The current study retrospectively investigated the...
The diagnosis of ameloblastic carcinoma is often difficult and the optimal treatment methods remain controversial. The current study retrospectively investigated the optimal diagnosis and treatment methods of 12 ameloblastic carcinoma patients at the West China Hospital of Stomatology, Sichuan University (Chengdu, China), and 20 patients selected from the PubMed database, were reviewed. The clinical features, diagnosis and outcome of the different treatments were evaluated. Ameloblastic carcinoma occurred in 12 out of a total of 538 ameloblastoma patients; the majority were of the primary type. Of the 538 ameloblastoma patients, 294 were male, 244 were female with a male to female ratio of 1.2:1. The predilection age is 20-30 years, which accounts for 40% of the total. In total, 461 cases were in the mandible and 77 were located in the maxilla. The cure rate of the primary type and the recurrence rate of the secondary type tumors were higher in the patients from the West China Hospital of Stomatology compared with those reported in the literature. In particular, a case with a long-term survival of 30 years is presented, which is considered to be relatively rare. The evolution of the clinical course has experienced three stages: Ameloblastoma (1978) followed by metastatic ameloblastoma (2000) and finally ameloblastic carcinoma (2008). To avoid recurrence, wide local excision with postoperative radiation therapy is required. While novel therapeutic regimens should also be considered as appropriate, including carbon ion therapy and Gamma Knife stereotactic radiosurgery. However, controlled studies with larger groups of patients are required to increase the accuracy of results.
PubMed: 25013517
DOI: 10.3892/ol.2014.2230 -
Journal of Oral Pathology & Medicine :... Nov 2005A case of ameloblastic carcinoma containing melanocyte and melanin in a 66-year-old male with swelling and an ulcerating firm mass in the left submandibular region is... (Review)
Review
A case of ameloblastic carcinoma containing melanocyte and melanin in a 66-year-old male with swelling and an ulcerating firm mass in the left submandibular region is presented. The diagnosis was confirmed by biopsy. The current histopathological diagnosis and management are discussed.
Topics: Aged; Biopsy; Dendritic Cells; Follow-Up Studies; Humans; Male; Mandibular Neoplasms; Melanins; Melanocytes; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasms, Second Primary; Odontogenic Tumors
PubMed: 16202083
DOI: 10.1111/j.1600-0714.2005.00306.x -
National Journal of Maxillofacial... Jan 2012Ameloblastic carcinoma (AC) is a rare malignant lesion with characteristic histologic features and clinical behavior that dictates a more aggressive surgical approach...
Ameloblastic carcinoma (AC) is a rare malignant lesion with characteristic histologic features and clinical behavior that dictates a more aggressive surgical approach than that of a simple ameloblastoma. The tumor cells resemble the cells seen in ameloblastoma, but they show cytologic atypia. Direct extension of the tumor, lymph node involvement, and metastasis to various sites (frequently the lung) have been reported. Wide local excision is the treatment of choice. Regional lymph node dissection should be considered and performed selectively. Literature shows that radiotherapy and chemotherapy is of limited value for the treatment of AC. A case of AC of maxillary region is presented here. Clinical/histological characteristics of this tumor and current knowledge on the classification of odontogenic malignancies are also discussed.
PubMed: 23251064
DOI: 10.4103/0975-5950.102169 -
Oral Surgery, Oral Medicine, Oral... May 2014Owing to the rarity of publications describing ameloblastic carcinoma, little is known about this entity in pediatric patients. To our knowledge, malignant...
Owing to the rarity of publications describing ameloblastic carcinoma, little is known about this entity in pediatric patients. To our knowledge, malignant transformation from an odontogenic cyst into an ameloblastic carcinoma in a pediatric patient has not been documented to date. We present the case of a 14-year-old boy in whom a large osteolytic lesion associated with an impacted right maxillary third molar germ was fortuitously detected by orthopanoramic radiography. With a preoperative clinical-radiographic diagnosis of odontogenic cyst, the patient underwent surgical enucleation of the lesion. Histologic evaluation rendered a diagnosis of follicular cyst with a focal area of ameloblastic carcinoma. The literature addressing ameloblastic carcinoma is reviewed.
Topics: Adolescent; Ameloblastoma; Diagnosis, Differential; Humans; Male; Maxillary Neoplasms; Odontogenic Cysts; Radiography, Panoramic
PubMed: 24184061
DOI: 10.1016/j.oooo.2013.08.012 -
The British Journal of Oral &... Apr 1989
Topics: Ameloblastoma; Humans; Odontogenic Tumors
PubMed: 2713320
DOI: 10.1016/0266-4356(89)90068-5 -
Oral Surgery, Oral Medicine, and Oral... Feb 1984The World Health Organization defines malignant ameloblastoma as a lesion exhibiting features of an ameloblastoma in primary and metastatic growths. To cases collected... (Review)
Review
The World Health Organization defines malignant ameloblastoma as a lesion exhibiting features of an ameloblastoma in primary and metastatic growths. To cases collected from the literature we have added two of our own cases in which features of an ameloblastoma were coupled with malignant behavior. It was noted that the diagnosis of "malignant ameloblastoma" is at present used in a rather indiscriminate way, resulting in the grouping of lesions that exhibit considerable differences in biological behavior and histomorphology. This might be due to the fact that the WHO classification emphasizes metastasis as a diagnostic criterion but is rather vague in defining histopathologic aspects. It is advocated that the term malignant ameloblastoma be reserved for those lesions that, in spite of a seemingly innocuous histology, have given origin to metastatic growths, while the WHO classification should be modified to include ameloblastic carcinoma as a diagnostic term for lesions that combine features of an ameloblastoma with a less-differentiated histomorphology.
Topics: Aged; Ameloblastoma; Chronic Disease; Epithelium; Female; Humans; Jaw Neoplasms; Male; Mandible; Maxilla; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Terminology as Topic
PubMed: 6366686
DOI: 10.1016/0030-4220(84)90207-x