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Robinson L, Abreu LG, Fonseca FP, Hunter KD, Ambele MA, van Heerden WFP. Ameloblastic carcinoma: A systematic review. J Oral Pathol Med 2024; 53:174-181. [PMID: 38368851 DOI: 10.1111/jop.13517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/05/2024] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Ameloblastic carcinoma (AC) is the most common odontogenic malignancy, constituting approximately 30% of cases in this category. Literature is sparse on malignant odontogenic neoplasms, with a large proportion of current knowledge derived from case reports or small case series. METHODS A systematic review of case series/case reports of AC was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Statement guidelines. Demographic and clinical information, including duration of the lesion, location, clinical presentation and radiologic features, were analysed. Additionally, the origin of the lesion (primary/secondary), Ki-67 proliferation index, treatment performed, metastasis, tumour recurrence and prognosis were collected for analysis. RESULTS A total of 126 studies, including 285 individual cases of AC, were included in this review. Patients presented with a near-equal distribution of painless and painful swellings. ACs presented at a median age of 45 years, with a male-to-female ratio of 1:2. The mandible was most frequently involved, with rare cases extending to involve more than one region, including crossing the midline. Although most lesions presented with poorly-demarcated borders (52.6%), unilocular lesions with well-demarcated borders (47.4%) comprised a substantial number in the sample. The proliferation index was only reported in 27 cases, with a mean score of 42% and a wide range. The probability of tumour recurrence increased, and the survival probability decreased with prolonged follow-up duration. CONCLUSION This study provides more comprehensive, up-to-date descriptive data on these rare odontogenic malignancies, aiding clinicians and Pathologists with the diagnosis and surgeons in their management of cases.
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Affiliation(s)
- Liam Robinson
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Members of an International Consortium on Odontogenic Tumours
| | - Lucas Guimarães Abreu
- Department of Paediatric Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Keith D Hunter
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Members of an International Consortium on Odontogenic Tumours
- Liverpool Head and Neck Centre, Molecular and Clinical Cancer Medicine Unit, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Melvin A Ambele
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Willie F P van Heerden
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Members of an International Consortium on Odontogenic Tumours
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John S, Ramya S, Verma S, Samadi FM, Gupta S. Clear and Spindle Cell Dedifferentiation in Ameloblastic Carcinoma: A Case Report on a Uncommon Phenomenon. Indian J Otolaryngol Head Neck Surg 2024; 76:1229-1233. [PMID: 38440659 PMCID: PMC10908652 DOI: 10.1007/s12070-023-04232-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/11/2023] [Indexed: 03/06/2024] Open
Abstract
Ameloblastic carcinoma is a rare malignant neoplasm with characteristic histopathological features that are directed towards an aggressive surgical approach than benign odontogenic lesions. It affects people of all ages, mostly in the posterior mandible, without a preference for race or gender. De novo cancer is one of its primary types, while the second type is defined as a malignant change from an antecedent case of benign ameloblastoma. The rapid progression of molecular biology led to the revelation that ameloblastoma contains a BRAF-V600E genetic mutation over 60%. Besides conventional ameloblastic carcinomas, rare histologic variants have also been described in the literature, including clear and spindle cells. These variants pose diagnostic challenges as to whether it is a dedifferentiation or a distinct entity. The dearth of data lends credence to the notion that these histologic variations are related to high-grade neoplasms and more aggressive outcomes. As a result, the current report intends to analyze a series of patients diagnosed with conventional ameloblastic carcinoma of the head and neck region with spindle and clear cell types along with a brief assessment of the literature.
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Affiliation(s)
- Sharon John
- Department of Oral Pathology, King George’s Medical University, Lucknow, UP 226003 India
| | - S. Ramya
- Department of Oral Pathology, King George’s Medical University, Lucknow, UP 226003 India
| | - Saloni Verma
- Department of Oral Pathology, King George’s Medical University, Lucknow, UP 226003 India
| | - Fahad M. Samadi
- Department of Oral and Maxillofacial Pathology, King George’s Medical University, Lucknow, UP 226003 India
| | - Shalini Gupta
- Department of Oral and Maxillofacial Pathology, King George’s Medical University, Lucknow, UP 226003 India
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Alloplastic Temporomandibular Joint Reconstruction Following Recurrent Ameloblastoma Resection. J Craniofac Surg 2021; 33:284-288. [PMID: 34510060 DOI: 10.1097/scs.0000000000008124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Ameloblastomas are benign tumors that most commonly affecting the mandible. The current standard of treatment for ameloblastomas is resection followed by reconstruction that has historically been accomplished through the use of a microsurgical vascularized flaps taken from the iliac crest or fibula. Alloplastic reconstruction methods have gained popularity over recent years with success reported in the reconstruction of many pathologies, including ankylosis, condylar fracture, neoplasia involving extensive resection, severe inflammatory/degenerative temporomandibular joint (TMJ) disease, and congenital TMJ abnormalities. The authors present a patient who successfully underwent ameloblastoma resection and TMJ reconstruction with a custom TMJ Concepts alloplastic implant. The authors also present a review of the literature on alloplastic TMJ reconstruction following ameloblastoma resection. To our knowledge, this is the second report in the literature on the use of a TMJ Concepts implant after ameloblastoma resection.
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Salehani A, Mooney J, Lepard J, Hackney JR, Harmon D. Rare Ameloblastic Carcinoma Metastasis to the Cervical Spine: A Case Report. Neurosurgery 2021; 88:E537-E542. [PMID: 33611519 DOI: 10.1093/neuros/nyab044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/26/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND IMPORTANCE Ameloblastic carcinoma (AC) is a malignant neoplasm of epithelial origin that typically arises from the mandible or maxilla. It represents approximately 2% of all odontogenic tumors. Gross total resection is the surgical goal given AC's aggressiveness and propensity for recurrence. We present the first reported AC metastasis to the cervical spine. CLINICAL PRESENTATION A 61-yr-old African American female with a history of AC of bilateral mandibles and lung metastases presented with neck pain and right arm weakness progressive over several months. Cervical spine imaging demonstrated a cervical 3 pathological fracture with severe anterior vertebral body compression and resultant cervical 2-3 kyphotic deformity and bony retropulsion causing severe cord compression. The patient underwent a cervical 3 corpectomy and cervical 2-4 anterior fixation followed by a cervical 3 laminectomy and cervical 2-5 dorsal internal fixation and fusion. Postoperatively, the patient's neurological exam remained stable and imaging showed improved spinal alignment and appropriate anterior and posterior instrumentation. Unfortunately, the patient thereafter suffered a decline in performance status and progression of lung metastatic disease. Her oncology team is considering chemotherapy and stereotactic radiosurgery, but her prognosis remains grim. CONCLUSION AC is a rare and aggressive pathology with a poor prognosis despite multimodal therapy. We present the first case of AC metastatic spread to the spine. We aim to bring this pathology to the attention of our worldwide neurosurgical colleagues and share our surgical approach and multidisciplinary management to assist those who may encounter this pathology in the future.
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Affiliation(s)
- Arsalaan Salehani
- Department of Neurosurgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
| | - James Mooney
- Department of Neurosurgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
| | - Jacob Lepard
- Department of Neurosurgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
| | - James R Hackney
- Division of Neuropathology, Department of Pathology, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
| | - Daniel Harmon
- Department of Neurosurgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
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Ameloblastic Carcinoma in a 2-Year-Old Child: A Case Report and Review of the Literature. Case Rep Dent 2020; 2020:4072890. [PMID: 32774938 PMCID: PMC7395988 DOI: 10.1155/2020/4072890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 11/30/2022] Open
Abstract
Ameloblastic carcinoma (AC) is a rare malignant odontogenic tumor in pediatric patients, only 22 cases have been reported in literature since 1932. We present an extremely rare case in which AC occurred in a 2-year-old girl, who had a tumor in the right mandible. Radiographic findings showed a multilocular, poorly defined, and mixed radiolucent-radiopaque lesion in the region of teeth #84 to #85, with bone and tooth root resorption. Computed tomography revealed buccal cortex destruction, tumor infiltration of soft tissue, and enlarged nodes. Incisional biopsy showed histomorphological features of AC. Immunohistochemical analysis exhibited a positive result for Cytokeratin (CK) 19 and overexpression of p53 and Ki67. The patient underwent right hemimandibulectomy and neck dissection. The final pathology was consistent with the initial diagnosis of AC. The patient did not exhibit signs of recurrence or metastasis within 2 years postoperatively. Given the rarity of this disease and the age of the patient, this report constitutes a valuable contribution to the current literature.
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Kalwagadda S, Kumar B, Nair SC, Shah AK, Shroff SS. Management of Ameloblastoma with Free Tissue Flap in Comparison with Other Reconstructive Options Available. J Maxillofac Oral Surg 2020; 19:283-288. [PMID: 32346241 DOI: 10.1007/s12663-019-01203-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 02/13/2019] [Indexed: 11/25/2022] Open
Abstract
Aim To review the management and reconstruction of ameloblastoma of mandible in different age groups over a period of 11 years. Methodology This retrospective study includes 51 cases operated in the Maxillofacial Unit, Bhagwan Mahaveer Jain Hospital, Bangalore, from the year 2007 to 2017. The data of these patients were collected to record demographic data such as age, gender with site of tumour and type of reconstruction after resection, follow-up period and incidence of complications. This study evaluated the outcome in terms of aesthetics, function and choice of reconstruction in different age groups. Results Most patients were of 21-40 age group. 37 (72.5%) were found to be unicystic ameloblastoma. 41 (80.3%) patients underwent reconstruction following the resection. There was a change in trend seen over a period of time with free grafts and reconstruction plate being historical, except in special situations like old age and unfit patients. According to one-way ANOVA and Tukey's post hoc analysis, free flaps were known to take a longer duration (mean = 503 min) compared to other modes of reconstruction. However, free grafts and free flaps were demonstrated to have a good facial contour and speech with most cases dentally rehabilitated with implants. Among the complications, 1 (16%) case with reconstruction plate showed screw loosening, 2 (28%) cases with free grafts showed graft exposure, and 1 (3.5%) case with free flap had venous congestion, making free flaps the most reliable option. Conclusion Free fibula is the gold standard of mandible reconstruction, but depending on age, medical condition, economic status and size of the defect other modes of reconstruction can be chosen with the acceptance of suboptimal results.
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Affiliation(s)
- Sowjanya Kalwagadda
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Balasubramanya Kumar
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Sanjiv C Nair
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Anjan Kumar Shah
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Sunil S Shroff
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
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Fahradyan A, Odono L, Hammoudeh JA, Howell LK. Ameloblastic Carcinoma In Situ: Review of Literature and a Case Presentation in a Pediatric Patient. Cleft Palate Craniofac J 2018; 56:94-100. [PMID: 29715060 DOI: 10.1177/1055665618774021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Ameloblastic carcinomas are rare malignant lesions with 3 mandibular pediatric cases reported in the literature. We present a case of ameloblastic carcinoma in situ in a 15-year-old male with a right mandibular cystic lesion on computed tomography. The incisional biopsy revealed plexiform ameloblastoma. Due to the infiltrating and aggressive nature of the tumor, the patient underwent hemimandibulectomy and immediate reconstruction with a vascularized osteocutaneous fibula free flap. The final pathology was read as ameloblastic carcinoma in situ. Given the rarity of this disease in the pediatric population, this case report may be a valuable addition to the current literature.
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Affiliation(s)
- Artur Fahradyan
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Lauren Odono
- 2 Division of Oral and Maxillofacial Surgery, Ostrow School of Dentistry of USC, Los Angeles, CA, USA
| | - Jeffrey A Hammoudeh
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.,2 Division of Oral and Maxillofacial Surgery, Ostrow School of Dentistry of USC, Los Angeles, CA, USA.,3 Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Lori Kathryn Howell
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.,3 Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
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Reconnoitre ameloblastic carcinoma: A prognostic update. Oral Oncol 2018; 77:118-124. [PMID: 29362117 DOI: 10.1016/j.oraloncology.2017.12.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/28/2017] [Accepted: 12/23/2017] [Indexed: 12/13/2022]
Abstract
AIM Malignant odontogenic tumor, ameloblastic carcinoma (AC) is challenging to study owing to its rarity, complexity and limited availability of literature. This further makes it difficult to establish its clinical characteristics and prognosis. Our study aimed to evaluate AC's clinico-demographic factors and their relation with prognosis and survival. MATERIALS AND METHODS Literature was systematically reviewed for cases pertaining to AC, starting from January 2000 to December 2016. All the required data was obtained, arranged and analysed using Cox regression ratio and Kaplan Meir survival analysis. From the database, 153 cases were retrieved as per the inclusion/exclusion criteria. RESULTS The results demonstrated that age of patient, mode of treatment and metastasis affects overall survival. The categorisation of AC as primary or secondary type does not have any role in determining prognosis. CONCLUSION Overall survival of AC patient depends upon age, site, treatment and metastasis. For a better prognosis early surgical management of the tumor appears to be the most favourable mode of treatment.
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Pandey S, Bhutia O, Roychoudhury A, Arora A, Bhatt K. Literature review of 86 cases of mandibular ameloblastic carcinoma. Natl J Maxillofac Surg 2018; 9:2-7. [PMID: 29937652 PMCID: PMC5996641 DOI: 10.4103/njms.njms_33_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Ameloblastic carcinoma is considered to be a rare epithelial malignant neoplasm of odontogenic origin occurring mainly in the mandible. Ameloblastic carcinoma has been a topic of controversy regarding management from past many years. We reviewed 86 cases of mandibular ameloblastic carcinoma from 1981 to 2014, on the basis of the electronic search of peer-reviewed journals in MEDLINE (PubMed) database. Age, sex, tumor size, treatment delivered, recurrence, metastasis, follow-up period, and dead/alive status are tabulated, and the data are analyzed. The mean age was 43.47 years with standard deviation ± 21.09. The age range was between 15 and 91 years, and male to female ratio was 2.18:1. Knowledge gained from the present review would help in establishing the best therapeutic options for ameloblastic carcinoma, and it also encourages the further reporting of ameloblastic carcinoma.
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Affiliation(s)
- Sandeep Pandey
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ongkila Bhutia
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ajoy Roychoudhury
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ankit Arora
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Krushna Bhatt
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
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Loyola AM, Cardoso SV, de Faria PR, Servato JPS, Eisenberg ALA, Dias FL, Accioly MTS, Gomes CC, Gomez RS, Souza SOMC, dos Santos JN. Ameloblastic carcinoma: a Brazilian collaborative study of 17 cases. Histopathology 2016; 69:687-701. [DOI: 10.1111/his.12995] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 05/14/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Adriano M Loyola
- Department of Oral and Maxillofacial Pathology; Federal University of Uberlândia; Uberlândia MG Brazil
| | - Sergio V Cardoso
- Department of Oral and Maxillofacial Pathology; Federal University of Uberlândia; Uberlândia MG Brazil
| | - Paulo R de Faria
- Department of Morphology; Biomedical Science Institute; Federal University of Uberlândia; Uberlândia MG Brazil
| | - João P S Servato
- Department of Oral and Maxillofacial Pathology; Federal University of Uberlândia; Uberlândia MG Brazil
| | - Ana L A Eisenberg
- Division of Pathology; Catholic University of Rio de Janeiro; Rio de Janeiro RJ Brazil
| | - Fernando L Dias
- Division of Head and Neck Surgery; Brazilian National Institute of Cancer and Post Graduate School of Medicine; Catholic University of Rio de Janeiro; Rio de Janeiro RJ Brazil
| | - Maria T S Accioly
- Division of Pathology; Catholic University of Rio de Janeiro; Rio de Janeiro RJ Brazil
| | - Carolina C Gomes
- Department of Pathology; Federal University of Minas Gerais; Belo Horizonte MG Brazil
| | - Ricardo S Gomez
- Department of Oral Surgery and Pathology; Federal University of Minas Gerais; Belo Horizonte MG Brazil
| | - Suzana O M C Souza
- Department of Oral Pathology; University of São Paulo; São Paulo SP Brazil
| | - Jean N dos Santos
- Department of Oral and Maxillofacial Pathology; Federal University of Bahia; Salvador BA Brazil
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Ameloblastic carcinoma (secondary type) with extensive squamous differentiation areas and dedifferentiated regions. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:e154-61. [DOI: 10.1016/j.oooo.2015.09.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 09/21/2015] [Accepted: 09/24/2015] [Indexed: 12/28/2022]
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12
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Ameloblastoma: a clinical review and trends in management. Eur Arch Otorhinolaryngol 2015; 273:1649-61. [DOI: 10.1007/s00405-015-3631-8] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 04/15/2015] [Indexed: 12/22/2022]
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13
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Sozzi D, Morganti V, Valente GM, Moltrasio F, Bozzetti A, Angiero F. Ameloblastic carcinoma in a young patient. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:e396-e402. [DOI: 10.1016/j.oooo.2013.08.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 07/30/2013] [Accepted: 08/18/2013] [Indexed: 10/26/2022]
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14
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Woo SB. Odontogenic Tumors. ORAL PATHOLOGY 2012:340-381. [DOI: 10.1016/b978-1-4377-2226-0.00015-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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