Distant metastasis of intraosseous dentinogenic ghost cell tumour to the donor site of a bone graft.

A dentinogenic ghost cell tumour (DGCT) is an extremely rare odontogenic tumour which is considered as a solid, neoplastic variant of calcifying odontogenic cyst. Intraosseous DGCTs are more aggressive than extraosseous DGCTs and have a high propensity for local recurrence. This report describes a case of a diagnosis of recurrent DGCT at the primary site and a distant donor site. A 25-year-old female patient visited a dental hospital for a complaint of facial swelling for the previous month. Incisional biopsy was performed and the specimen was diagnosed as DGCT. Partial mandibulectomy for tumour resection and iliac bone graft was performed. 2 years later, the tumour recurred on the mandible and iliac bone. The recurrent lesion on the donor site was diagnosed as metastasized DGCT. This report highlights the possibility of distant metastasis occurring at a graft donor site.

Ameloblastic carcinoma, secondary type, of the mandible: a case report.

Ameloblastic carcinoma is a rare, odontogenic, malignant tumor that has features of ameloblastoma in addition to cytologic atypia with or without metastasis. It is classified as primary type; secondary type, intraosseous; and secondary type, peripheral according to the World Health Organization classification of 2005. Ameloblastic carcinoma, secondary type, is extremely rare, and few cases have been reported in the English-language literature. The authors report a case of ameloblastic carcinoma, secondary type, arising at the mandible in a 17-year-old Japanese boy.

Clear cell carcinoma and clear cell odontogenic carcinoma: a comparative clinicopathologic and immunohistochemical study.

Clear cell carcinoma or hyalinizing clear cell carcinoma (CCC) and clear cell odontogenic carcinoma (CCOC) are rare, low-grade and typically indolent malignancies that can be diagnostically challenging. In this study the clinicopathologic, histologic, and immunohistochemical features of 17 CCCs and 12 CCOCs are examined. The differential diagnosis of clear cell malignancies in the head and neck is discussed. The relationship of CCCs and CCOCs to other clear cell tumors on the basis of their immunohistochemical staining patterns is postulated.

Ameloblastic carcinoma of the mandible with metastasis to the skull and lung: advanced imaging appearance including computed tomography, magnetic resonance imaging and positron emission tomography computed tomography.

Ameloblastic carcinoma is a very rare malignant odontogenic tumour with characteristic histopathological and clinical features, which requires aggressive surgical treatment and surveillance and, therefore, differs from ameloblastoma. Metastasis typically occurs in the lung. Only one patient with metastasis to the skull has previously been described and no prior case reports have presented MRI and positron emission tomography-CT (PET-CT) imaging findings. We describe a case of ameloblastic carcinoma with metastasis to the skull and lung with emphasis on imaging features including MRI and PET-CT.

Total mandibular reconstruction after resection of rare "honeycomb-like" ameloblastic carcinoma--a case report.

PURPOSE: This case report describes a rare and aggressive ameloblastic carcinoma that infiltrated the mandible in a "honeycomb" pattern. METHODS: A total mandibulectomy with bilateral modified neck dissection was followed by primary reconstruction with a single free vascularised fibula flap. RESULTS: The postoperative course was uneventful. The one year follow-up revealed no signs of recurrent tumour or metastases. Nine months later distant metastases occurred in the lung. CONCLUSION: Ameloblastic carcinoma is a highly malignant lesion, which requires aggressive therapy. Prognosis is poor. Further reporting of ameloblastic carcinoma is encouraged.

Malignant transformation of ameloblastic fibroma to ameloblastic fibrosarcoma: case report and review of the literature.

INTRODUCTION: Ameloblastic fibrosarcoma is a rare malignant odontogenic tumour and is regarded as the malignant counterpart of the ameloblastic fibroma. The epithelial component remains benign, but the mesenchymal component becomes malignant. The diagnosis is made by histopathology. PATIENT: The case of a 26-year-old man who underwent curettage of an ameloblastic fibroma and died of an ameloblastic fibrosarcoma is presented, and the course of malignant transformation is analysed retrospectively. CONCLUSION: One-third of ameloblastic fibrosarcoma cases seem to have developed from recurrent ameloblastic fibromas. Knowledge of the malignant potential in the mesenchymal spindle cells of ameloblastic fibroma will assist in determining the management of these benign tumours, and may prevent malignant transformation to ameloblastic fibrosarcoma.

Metastasising clear cell odontogenic carcinoma: a case report and review of the literature.

Primary odontogenic carcinomas are rare and examples which have metastasised are even more uncommon. We describe the first reported case of a clear cell odontogenic carcinoma which metastasised to distant bones, namely the 5th lumbar vertebra and hip, 3 years after initial diagnosis. The initial incisional biopsy was thought to represent a calcifying epithelial odontogenic tumour, but in the subsequent resection the tumour showed a prominent clear cell component admixed with squamous cells showing peripheral palisading, widespread infiltration and necrosis indicating a malignant neoplasm. Radiologically guided biopsy revealed a metastatic lesion in L5 vertebrae and left hip, confirmed by immunohistochemistry. The metastatic lesion had similar appearances to the first biopsy, and diagnosis was confirmed by comparison of histological features, immunohistochemistry and exclusion of a second primary lesion by clinical examination and imaging. The diagnosis of clear cell odontogenic carcinoma is a difficult one to make. The behaviour of these tumours is unpredictable. This case confirms that clear cell odontogenic carcinomas have the potential for distant metastasis and require long-term follow up.

Malignant epithelial odontogenic tumors.

Malignant epithelial odontogenic tumors are very rare. They may arise from the epithelial components of the odontogenic apparatus. The rests of Malassez, the reduced enamel epithelium surrounding the crown of an impacted tooth, the rests of Serres in the gingiva, and the linings of odontogenic cysts represent the precursor cells for malignant transformation. Because metastatic carcinoma is the most common malignancy of the jaws, the diagnosis of a primary intraosseous carcinoma must always be made to the exclusion of metastatic disease. Odontogenic carcinomas include malignant (metastasizing) ameloblastoma, ameloblastic carcinoma, primary intraosseous squamous cell carcinoma, clear cell odontogenic carcinoma, and malignant epithelial ghost cell tumor. There are specific histopathologic features that support the diagnosis of a primary carcinoma of odontogenic epithelium which are presented in this article. Immunohistochemical (IHC) staining is important for distinguishing clear cell odontogenic carcinoma from metastatic renal cell tumors, yet IHC stains are not particularly helpful for other lesions in this group-all of which exhibit low molecular weight cytokeratin positivity. Aggressive growth and nodal and distant metastases occur with all of these entities.

[Ameloblastic carcinoma. Apropos of a case]. / Carcinome améloblastique. A propos d'un cas.

Ameloblastic carcinoma is an exceptionally rare odontogenic tumor. Ameloblastoma is considered malignant if there is evidence of metastasis or histological features of malignancy. Present classification of these tumors is debated. Several authors use the term malignant ameloblastoma for tumours that metastasize despite "benign" histological features whereas ameloblastic carcinoma is referred to as a tumor with malignant histological features regardless of its metastatic potential. We report a case of mandibular ameloblastic carcinoma with cervical lymph node metastasis in a 70-year-old man, documented by MRI and CT. We discuss current knowledge on these tumors.

Ameloblastic carcinoma of the mandible.

BACKGROUND: Ameloblastic carcinoma is a rare, aggressive odontogenic neoplasm of the jaws in which the epithelial cells exhibit cytologic features of recognizable ameloblastoma and malignancy. Cases with metastasis have been infrequently reported. METHODS: A case of a 64-year-old white woman with mandibular ameloblastic carcinoma with documented distant metastasis is presented. The patient's presenting symptoms included facial asymmetry of the right jaw over 2 months and the development of moderate trismus. Clinical manifestations, pathology, treatment, and biologic behavior are discussed. The nomenclature and classification of odontogenic carcinomas are reviewed, including entities that should be considered in the differential diagnosis. RESULTS: The patient underwent surgical resection consisting of mandibulectomy, parotidectomy, and modified radical neck dissection followed by radiation to both necks and tumor bed. Postsurgically, the patient developed pulmonary metastasis at 11 months and expired with widespread metastatic disease at 28 months. CONCLUSIONS: This case demonstrated an unusual behavior pattern in that local recurrence and regional metastasis did not occur. Distant metastasis occurred despite apparent adequate control of the primary mandibular tumor. The ameloblastic carcinoma is a highly malignant neoplasm which requires aggressive therapy. Prognosis is poor. Further reporting of ameloblastic carcinoma is encouraged.

Intraosseous carcinoma arising from mandibular ameloblastoma with progressive invasion and pulmonary metastasis.

A 60-year-old woman, who had undergone curettage of a mandibular ameloblastoma about 20 years before, presented with recurrence of an ameloblastoma in the mandibular symphysis. This tumor was removed by a marginal resection. About 2 years later, the tumor recurred in the right mandibular ramus, and the patient underwent right mandibulectomy. About 6 months later, the tumor again recurred. Radical resection was performed, but invasion of the infraorbital region and cranial base was noted. An anterior craniotomy was then performed and the lesion removed. Histologically, proliferation of squamous cells associated with atypia was seen, and ameloblastic features were no longer observed. Metastasis to the lung was noted 1 year later.

Maxillary odontogenic carcinoma with distant metastasis to axillary skin, brain, and lung: case report.

We present a case of odontogenic carcinoma with ghost-cell keratinization of the right maxilla, with a history of 23 years after initial treatment. Within this period, multiple local recurrence, as well as metastasis to axilla, brain, and lung, was noted. Several attempts at resection of the primary lesion were unsuccessful at achieving local control, even when supplemented with chemotherapy and radiotherapy. Metastatic tumors were studied histologically, and their morphology coincided with that of the primary tumor. The medical history of the patient and pathologic findings of the tumor are reviewed.

Clear cell odontogenic carcinoma. Report of a case with lymph node and pulmonary metastases.

The authors present a case of a rare type of odontogenic tumour, recently described as "clear cell odontogenic tumour". The patient died 5 years after the initial diagnosis with lymph node and diffuse pulmonary metastases. This fact can support the view that this tumour, histologically characterised by the presence of cells with a clear cytoplasm, can behave in an aggressive way and has true metastatic potential, despite the absence of malignant cellular features.

Primary intraosseous carcinoma: review of the literature and diagnostic criteria.

Twenty-four reports describing 39 cases of primary intraosseous carcinoma (PIOC) were reviewed and the clinicopathologic features were summarized. The mean age of the patients at the time of diagnosis was 51.0 years, and the male: female ratio was 2:3. The posterior mandible was the predominant site; in no patient was a lesion observed in the posterior maxilla. Twenty-five of 31 patients (80.6%) showed swelling of the oral mucosa. However, ulcer formation was observed in only 3 of 36 patients. Pain, sensory disturbances, and metastasis to regional lymph nodes were observed in 25 of 34 patients (73.5%), 9 of 15 patients (60%), and 13 of 33 patients (39.4%), respectively. Radiographically, most lesions produced bone resorption with ill-defined margins (51.6%) or with well-defined margins (19.4%). The diagnostic criteria proposed for PIOC are absence of ulcer formation, except when caused by other factors; histologic evidence of squamous cell carcinoma without a cystic component or other odontogenic tumor cells; and absence of another primary tumor on chest radiographs obtained at the time of diagnosis and during a follow-up period of more than 6 months.

Primary intraosseous squamous carcinoma. Report of two cases.

Two cases of primary intraosseous squamous carcinoma (PIOSC) are reported. One PIOSC is in the mandible of a 24-year-old man and appears to be a keratinizing PIOSC arising de novo. The other PIOSC presented in the edentulous maxilla of a 56-year-old man and was diagnosed as a PIOSC arising from an odontogenic cyst. The 2nd tumor subsequently metastasized to a cervical lymph node. Previous reports have noted a favorable prognosis for PIOC arising in odontogenic cysts, and only 3 other instances of metastases of a PIOSC in an odontogenic cyst have been documented.

Clear cell odontogenic carcinoma: report of three cases with pulmonary and lymph node metastases.

Three cases of a newly described rare odontogenic tumor are reported. One patient died with pulmonary metastases, one had an associated odontogenic cyst and one exhibited regional lymph node metastasis. The cases lend support to the odontogenic origin and metastatic capability of the clear cell odontogenic tumor. The authors recommend aggressive therapy and believe that the tumor should be considered a clear cell odontogenic carcinoma.