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Nancy PC, Selenne RSR, J. Valente FA. Ameloblastic carcinoma of the mandible: A case report. J Oral Maxillofac Pathol 2023; 27:233-237. [PMID: 37234302 PMCID: PMC10207186 DOI: 10.4103/jomfp.jomfp_339_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/24/2022] [Accepted: 12/16/2022] [Indexed: 05/27/2023] Open
Abstract
Ameloblastic carcinoma (AC) is a rare, primary epithelial odontogenic malignant neoplasm. It is the malignant counterpart of ameloblastoma. It comprises 1% of all cysts and tumours occurring in the jaws, arising from tissues associated with odontogenic epithelium. The objective of the present study was to describe a clinical case of a 63-year-old male with an enlargement in the mandible on the left side. Panoramic radiography revealed a radiolucent area with poorly defined borders, and an incisional biopsy was performed for the histopathological study using immunomarkers such as SOX2 and Ki-67. Ki-67 is considered a marker of cell proliferation, and SOX2 reportedly participates in the development of the ameloblastic epithelium lineage and is associated with a more aggressive clinical course. A final histopathological diagnosis of AC was given. Unfortunately, the patient died one week before surgical resection (the surgical treatment of choice for AC).
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Affiliation(s)
- Pérez C. Nancy
- Department of Oral and Maxillofacial Pathology, National Autonomous University of Mexico, Campus León, Guanajuato, México
| | - Romero-Servin R. Selenne
- Department of Oral and Maxillofacial Pathology, National Autonomous University of Mexico, Campus León, Guanajuato, México
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2
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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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3
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Study on clinical and biological characteristics of ameloblastic carcinoma. Orphanet J Rare Dis 2020; 15:316. [PMID: 33176823 PMCID: PMC7656674 DOI: 10.1186/s13023-020-01603-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ameloblastic carcinoma (AC) is an odontogenic malignant tumor which is closely related to benign ameloblastoma. Because of its rarity, diagnosis and treatment are difficult. In this study, we summarized and analyzed the clinical and biological characteristics of AC. RESULTS Fifteen patients with AC and a median age of 53 years were identified. Among of them, five patients who were tested carried a BRAF-V600E mutation. Two patients presented with cervical lymph nodes and lung metastases. Primary AC was more invasive, and the bone destruction ability of the primary type was more radical than that of the secondary type. CONCLUSIONS This study revealed that the BRAF-V600E mutation was related to the aggressive behavior of AC, and early radical resection is crucial. Moreover, targeted therapy may be a new direction in the future.
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Lapthanasupkul P, Klongnoi B, Mutirangura A, Kitkumthorn N. Investigation of PTEN promoter methylation in ameloblastoma. Med Oral Patol Oral Cir Bucal 2020; 25:e481-e487. [PMID: 32134893 PMCID: PMC7338066 DOI: 10.4317/medoral.23498] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/09/2019] [Indexed: 12/12/2022] Open
Abstract
Background Phosphatase and tensin homolog (PTEN) acts as a tumor suppressor gene. Inactivation of PTEN has been reported in various types of cancers. PTEN promoter methylation possibly underlies PTEN inactivation, which results in tumorigenesis. The aim of this study was to investigate whether PTEN promoter methylation contributes to PTEN inactivation in ameloblastoma and its associated protein expression.
Material and Methods In total, 20 fresh-frozen ameloblastoma samples were evaluated for PTEN promoter methylation using methylation-specific polymerase chain reaction (MS-PCR). A subset of 10 paraffin-embedded ameloblastoma samples was examined for PTEN expression through immunohistochemistry. Four primary cultured ameloblastoma cells were investigated for PTEN promoter methylation and PTEN transcriptional expression via reverse transcription PCR.
Results PTEN promoter methylation was detected in 65% (13/20) of the ameloblastoma samples. Of 10 ameloblastoma samples, 4 exhibited reduced PTEN expression. Of 5 samples with methylated PTEN, 3 (60%) were associated with loss of PTEN expression. However, PTEN expression was detected in 4 (80%) of 5 samples with unmethylated PTEN. In addition, 3 (75%) of 4 primary ameloblastoma cell cultures exhibited an inverse correlation between PTEN promoter methylation and PTEN transcription level.
Conclusions PTEN promoter methylation is found in a number of ameloblastomas but not significantly correlated with loss of PTEN expression. Genetic or epigenetic mechanisms other than PTEN promoter methylation may contribute to PTEN inactivation in ameloblastoma tumor cells. Key words:PTEN, promoter methylation, ameloblastoma.
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Affiliation(s)
- P Lapthanasupkul
- Department of Oral Biology Faculty of Dentistry, Mahidol University 6 Yothi Street, Bangkok, Thailand
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Kosanwat T, Poomsawat S, Juengsomjit R. Ameloblastic carcinoma ex ameloblastoma of the maxilla. J Oral Maxillofac Pathol 2019; 23:58-62. [PMID: 30967726 PMCID: PMC6421907 DOI: 10.4103/jomfp.jomfp_116_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ameloblastic carcinoma (AC) is a rare malignant odontogenic tumor. Approximately 138 cases were reported. The majority of these cases occurred in the mandible. Only 57 cases were located in the maxilla. Most of AC cases occur in a primary type. Little is known about AC secondary type (dedifferentiated) since only six cases have been reported. All of previous six cases occurred in the mandible. Here, we presented the first case of maxillary AC secondary type (dedifferentiated) in a 46-year-old female. The first excisional biopsy was diagnosed as basal cell ameloblastoma. Then, the patient underwent partial maxillectomy. A recurrence occurred 17 months later. At this time, tumor cells with cytological atypia were clearly detected. A diagnosis of AC was rendered. Two years later, the patient suffered from another recurrence and received a wide excision with a diagnosis of AC. We considered our case as AC secondary type (dedifferentiated). We discussed the histopathological findings that may be helpful in making a diagnosis of AC. In addition, we consider that the basaloid pattern may be related to malignant transformation in ameloblastoma.
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Affiliation(s)
- Theerachai Kosanwat
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Sopee Poomsawat
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Rachai Juengsomjit
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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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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7
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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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Moro A, Foresta E, Gasparini G, Pelo S, Forcione M, Cristallini EG, Toraldo M, Lorenzo C, Falchi M, Saponaro G. Ameloblastic carcinoma of the maxilla: A case report and an updated review of the literature. Oncol Lett 2016; 12:4339-4350. [PMID: 28105148 PMCID: PMC5228340 DOI: 10.3892/ol.2016.5272] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 07/12/2016] [Indexed: 11/16/2022] Open
Abstract
Ameloblastic carcinoma (AC) is an uncommon malignant odontogenic tumor that can be difficult to differentiate from ameloblastoma and can arise directly as an undifferentiated lesion or from a pre-existing benign lesion. The current study presents a novel case of primary maxillary AC and review the literature on AC of the maxilla. The review of the literature indicates that secondary tumors and posterior localization are associated with a higher tendency for recurrence and, often, multiple recurrences. Surgical therapy, eventually followed by radiotherapy, is the treatment modality most frequently applied, while the role of chemotherapy remains unclear. Several new cases of maxillary AC have been recently described in literature, making this pathology more frequent than previously considered; this is perhaps an indication of an increased diagnostic sensibility, rather than a real increase in the incidence of the disease itself.
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Affiliation(s)
- Alessandro Moro
- Maxillofacial Surgery Unit, Faculty of Medicine, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, I-00168 Rome
| | - Enrico Foresta
- Maxillofacial Surgery Unit, Faculty of Medicine, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, I-00168 Rome
| | - Giulio Gasparini
- Maxillofacial Surgery Unit, Faculty of Medicine, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, I-00168 Rome
| | - Sandro Pelo
- Maxillofacial Surgery Unit, Faculty of Medicine, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, I-00168 Rome
| | - Mario Forcione
- Maxillofacial Surgery Unit, Faculty of Medicine, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, I-00168 Rome
| | | | - Marco Toraldo
- Pathological Anatomy Service, Foligno Hospital, I-06034 Foligno, Italy
| | | | - Marco Falchi
- Department of Maxillofacial Surgery, Foligno Hospital, I-06034 Foligno, Italy
| | - Gianmarco Saponaro
- Maxillofacial Surgery Unit, Faculty of Medicine, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, I-00168 Rome
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Kodati S, Majumdar S, Uppala D, Namana M. Ameloblastic Carcinoma: A Report of Three Cases. J Clin Diagn Res 2016; 10:ZD23-ZD25. [PMID: 27891485 PMCID: PMC5121823 DOI: 10.7860/jcdr/2016/21100.8697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 06/16/2016] [Indexed: 11/24/2022]
Abstract
Malignant odontogenic tumours are rare and represent approximately 1% of all oral malignancies. Ameloblastic carcinoma is a rare odontogenic tumour, which is aggressive in nature with extensive local bone destruction that has retained the features of ameloblastic differentiation and also exhibits cytological features of malignancy. It occurs primarily in the mandible in a wide range of age groups. It may arise de-novo or in pre-existing ameloblastoma or odontogenic cyst. The purpose of this report is to present three cases of ameloblastic carcinoma with varying presentations as central and peripheral entities.
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Affiliation(s)
- Sravya Kodati
- Postgraduate Student, Department of Oral Pathology and Microbiology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Sumit Majumdar
- Professor and Head, Department of Oral Pathology and Microbiology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Divya Uppala
- Reader, Department of Oral Pathology and Microbiology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Madhurya Namana
- Postgraduate Student, Department of Oral Pathology and Microbiology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, 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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Safadi RA, Quda BF, Hammad HM. Immunohistochemical expression of K6, K8, K16, K17, K19, maspin, syndecan-1 (CD138), α-SMA, and Ki-67 in ameloblastoma and ameloblastic carcinoma: diagnostic and prognostic correlations. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 121:402-11. [PMID: 26972539 DOI: 10.1016/j.oooo.2015.11.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 11/18/2015] [Accepted: 11/26/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To identify cutoff values of markers that correlate with the histopathologic diagnosis of ameloblastic carcinoma (AC) and/or the increased recurrence potential of ameloblastoma (AB). STUDY DESIGN Immunohistochemical expression (IHCE) of 9 selected markers were investigated in 18 non-recurrent ameloblastomas (NRABs), 6 recurrent ameloblastomas (RABs), and 5 ACs. RESULTS No significant difference in IHCE of K6, K8, K16, K17, K18, K19, maspin, or syndecan-1 was observed among study groups. α Smooth muscle actin (α-SMA)-positive area in central epithelial cells significantly differentiated between AB and AC (P = .017; t -test). Ki-67 score significantly differentiated between AB and AC (P < .005; t -test) and between AC and RAB (P = .015; ANOVA/post hoc). CONCLUSIONS Ki-67 score of 75 cells/HPF (ROC curve) is a potential indicator of AC. Clinical recurrence of AB may be predicted by α-SMA expression pattern. Syndecan-1 and α-SMA may indicate a higher aggressive potential of AB when expressed in the stroma.
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Affiliation(s)
- Rima A Safadi
- Associate Professor, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
| | - Basma F Quda
- Oral Medicine Specialist, Ministry of Health, Zarqa, Jordan
| | - Huda M Hammad
- Associate Professor, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Rizzitelli A, Smoll NR, Chae MP, Rozen WM, Hunter-Smith DJ. Incidence and overall survival of malignant ameloblastoma. PLoS One 2015; 10:e0117789. [PMID: 25692490 PMCID: PMC4333213 DOI: 10.1371/journal.pone.0117789] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 12/31/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Malignant ameloblastoma, comprising metastasizing ameloblastoma and ameloblastic carcinoma, represents 1.6-2.2% of all odontogenic tumors. Due to its rare nature, malignant ameloblastoma has only been reported in the literature in small case series or case reports. Using the Surveillance, Epidemiology and End-Results (SEER) database, we have performed a population-based study to determine the incidence rate and the absolute survival of malignant ameloblastoma. METHOD Using the International Classification of Diseases for Oncology (ICD-O) codes 9310/3 and 9270/3, data from the SEER database were used to calculate the incidence rate and absolute survival rate of population with malignant ameloblastoma. RESULTS The overall incidence rate of malignant ameloblastoma was 1.79 per 10 million person/year. The incidence rate was higher in males than females and also higher in black versus white population. The median overall survival was 17.6 years from the time of diagnosis and increasing age was associated with a statistically significant poorer survival. CONCLUSIONS To our best knowledge, we report the largest population-based series of malignant ameloblastoma. The incidence rate was 1.79 per 10 million person/year and the overall survival was 17.6 years.
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Affiliation(s)
- Alexandra Rizzitelli
- Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199, Australia
| | - Nicolas R. Smoll
- Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199, Australia
- Department of Surgery, Monash University, Level 5, E Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Michael P. Chae
- Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199, Australia
- Department of Surgery, Monash University, Level 5, E Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
- Monash University Plastic and Reconstructive Surgery Unit (Peninsula Clinical School), Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199, Australia
| | - Warren M. Rozen
- Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199, Australia
- Department of Surgery, Monash University, Level 5, E Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
- Monash University Plastic and Reconstructive Surgery Unit (Peninsula Clinical School), Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199, Australia
- Department of Surgery, School of Medicine and Dentistry, James Cook University Clinical School, Level 1, Townsville Hospital, 100 Angus Smith Drive, Douglas, Townsville Queensland 4814, Australia
- * E-mail:
| | - David J. Hunter-Smith
- Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199, Australia
- Department of Surgery, Monash University, Level 5, E Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
- Monash University Plastic and Reconstructive Surgery Unit (Peninsula Clinical School), Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199, Australia
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