Limits...
Ameloblastic Carcinoma.

Gunaratne DA, Coleman HG, Lim L, Morgan GJ - Am J Case Rep (2015)

Bottom Line: It arises through carcinomatous de-differentiation of a pre-existing ameloblastoma or odontogenic cyst, typically following repeated treatments and recurrences of the benign precursor neoplasm.Herein, we report 1 such case.Radical surgical resection with adequate hard and soft tissue margins is essential for curative management of localized disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, Australia.

ABSTRACT

Background: Ameloblastic carcinoma secondary type is an extremely rare and aggressive odontogenic neoplasm that exhibits histological features of malignancy in primary and metastatic sites. It arises through carcinomatous de-differentiation of a pre-existing ameloblastoma or odontogenic cyst, typically following repeated treatments and recurrences of the benign precursor neoplasm. Identification of an ameloblastic carcinoma, secondary type presenting with histologic features of malignant transformation from an earlier untreated benign lesion remains a rarity. Herein, we report 1 such case.

Case report: A 66-year-old man was referred for management of a newly diagnosed ameloblastic carcinoma. He underwent radical surgical intervention comprising hemimandibulectomy, supraomohyoid neck dissection, and free-flap reconstruction. Final histologic analysis demonstrated features suggestive of carcinomatous de-differentiation for a consensus diagnosis of ameloblastic carcinoma, secondary type (de-differentiated) intraosseous.

Conclusions: Ameloblastic carcinoma, secondary type represents a rare and challenging histologic diagnosis. Radical surgical resection with adequate hard and soft tissue margins is essential for curative management of localized disease.

No MeSH data available.


Related in: MedlinePlus

(A) Ameloblastic carcinoma with area of necrosis. (B) Ameloblastic carcinoma with tumor cells exhibiting crowding, nuclear pleomorphism, and mitotic activity.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4492487&req=5

f3-amjcaserep-16-415: (A) Ameloblastic carcinoma with area of necrosis. (B) Ameloblastic carcinoma with tumor cells exhibiting crowding, nuclear pleomorphism, and mitotic activity.

Mentions: In June 2013, the patient underwent a right supraomohyoid neck dissection, right hemi-mandibulectomy (condyle sparing) via a midline lip-split, and right anterolateral thigh free-flap reconstruction for defect closure. Bony reconstruction was not considered appropriate given his performance status, habitus, and co-morbidities. Gross pathological review of the resected hemi-mandible revealed a variegated cream-to-tan colored tumor (measuring 23×21 mm) that expanded into the bone beneath the ulcerated mucosa. Microscopic examination confirmed the diagnosis of an ameloblastic carcinoma with features supportive of carcinomatous change (ex ameloblastoma). The tumor cells demonstrated peripherally palisading plexiform trabeculae, significant pleomorphism with frequent mitoses (> 12/10 high-power field), and areas of focal necrosis and chronic inflammation (Figure 3). Lymphovascular and perineural permeation was not apparent. All resected margins were clear and there was no evidence of nodal involvement. As such, no adjuvant treatment was required. The patient has remained free of disease in the 18 months of follow-up with OPG imaging at 12 months demonstrating no evidence of mandibular recurrence (Figure 4).


Ameloblastic Carcinoma.

Gunaratne DA, Coleman HG, Lim L, Morgan GJ - Am J Case Rep (2015)

(A) Ameloblastic carcinoma with area of necrosis. (B) Ameloblastic carcinoma with tumor cells exhibiting crowding, nuclear pleomorphism, and mitotic activity.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4492487&req=5

f3-amjcaserep-16-415: (A) Ameloblastic carcinoma with area of necrosis. (B) Ameloblastic carcinoma with tumor cells exhibiting crowding, nuclear pleomorphism, and mitotic activity.
Mentions: In June 2013, the patient underwent a right supraomohyoid neck dissection, right hemi-mandibulectomy (condyle sparing) via a midline lip-split, and right anterolateral thigh free-flap reconstruction for defect closure. Bony reconstruction was not considered appropriate given his performance status, habitus, and co-morbidities. Gross pathological review of the resected hemi-mandible revealed a variegated cream-to-tan colored tumor (measuring 23×21 mm) that expanded into the bone beneath the ulcerated mucosa. Microscopic examination confirmed the diagnosis of an ameloblastic carcinoma with features supportive of carcinomatous change (ex ameloblastoma). The tumor cells demonstrated peripherally palisading plexiform trabeculae, significant pleomorphism with frequent mitoses (> 12/10 high-power field), and areas of focal necrosis and chronic inflammation (Figure 3). Lymphovascular and perineural permeation was not apparent. All resected margins were clear and there was no evidence of nodal involvement. As such, no adjuvant treatment was required. The patient has remained free of disease in the 18 months of follow-up with OPG imaging at 12 months demonstrating no evidence of mandibular recurrence (Figure 4).

Bottom Line: It arises through carcinomatous de-differentiation of a pre-existing ameloblastoma or odontogenic cyst, typically following repeated treatments and recurrences of the benign precursor neoplasm.Herein, we report 1 such case.Radical surgical resection with adequate hard and soft tissue margins is essential for curative management of localized disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, Australia.

ABSTRACT

Background: Ameloblastic carcinoma secondary type is an extremely rare and aggressive odontogenic neoplasm that exhibits histological features of malignancy in primary and metastatic sites. It arises through carcinomatous de-differentiation of a pre-existing ameloblastoma or odontogenic cyst, typically following repeated treatments and recurrences of the benign precursor neoplasm. Identification of an ameloblastic carcinoma, secondary type presenting with histologic features of malignant transformation from an earlier untreated benign lesion remains a rarity. Herein, we report 1 such case.

Case report: A 66-year-old man was referred for management of a newly diagnosed ameloblastic carcinoma. He underwent radical surgical intervention comprising hemimandibulectomy, supraomohyoid neck dissection, and free-flap reconstruction. Final histologic analysis demonstrated features suggestive of carcinomatous de-differentiation for a consensus diagnosis of ameloblastic carcinoma, secondary type (de-differentiated) intraosseous.

Conclusions: Ameloblastic carcinoma, secondary type represents a rare and challenging histologic diagnosis. Radical surgical resection with adequate hard and soft tissue margins is essential for curative management of localized disease.

No MeSH data available.


Related in: MedlinePlus