RESUMEN
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.
Asunto(s)
Ameloblastoma/diagnóstico por imagen , Ameloblastoma/cirugía , Neoplasias Maxilares/diagnóstico por imagen , Neoplasias Maxilares/cirugía , Quistes Odontogénicos/diagnóstico por imagen , Quistes Odontogénicos/cirugía , Adolescente , Ameloblastoma/patología , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias Maxilares/patología , Quistes Odontogénicos/patología , Radiografía PanorámicaRESUMEN
OBJECTIVE: Nonsebaceous lymphadenomas are rare benign neoplasms. We emphasize the role of immunohistochemistry and attempt to elucidate the pathogenesis by investigating the distribution of 2 transcription factors, MYC and BLIMP1. STUDY DESIGN: A 70-year-old man was evaluated for a 3-cm left parotid mass. Ultrasound-guided fine-needle aspiration biopsy findings were suggestive of a diagnosis of pleomorphic adenoma. A left superficial parotidectomy was performed, and based on histopathology a diagnosis of lymphadenoma, nonsebaceous type, was rendered. RESULTS: The tumor was positive for AE1/3, CKA, BclII, P63, CD79a, CD3, and MYC; focally positive for CK7 and epithelial membrane antigen; and negative for CD10, calponin, CD117, and BLIMP1. CONCLUSIONS: The rarity of nonsebaceous lymphadenoma and its superficial resemblance to commoner salivary gland tumors may present a diagnostic challenge for pathologists. The expression of MYC in the ductal component and the differentiation-related expression of PRDM1 in the superficial keratinizing layers point to a potential role for these 2 transcription factors in the pathogenesis of this neoplasm.
