Browsing by Subject "odontogenic tumor"

Ameloblastic carcinoma – systematic literature review and a case report Aim of this study: The purpose of this study is to increase awareness of a rare malignant odontogenic tumor, ameloblastic carcinoma (AC). By increasing knowledge of this disease, AC patients can be diagnosed better and guide the treatment and follow up of the patients. Material and methods: In this study, literature dealing with AC in English was systematically reviewed from PubMed. In addition, one newly diagnosed AC patient case with HUSLAB pathology, University Hospital of Helsinki, Finland is reported. Results: Altogether, 33 studies fulfilling inclusion criteria were published between the years 1993 to 2021. There were studies of AC from almost all continents. There was a total of 211 patients in these articles. Sixty-one percent of the AC patients were men. The average age of the patients was 46.9 years. Most commonly, AC occured in the mandible. Primary AC was slightly more common than secondary malignant ameloblastoma derived AC. All AC patients were symptomatic. The most common symptoms were swelling, bleeding, pain, dysphagia, dysphonia, facial nerve paralysis, ulcer, drainage, trismus and tooth mobility. Metastases occurred in 22.4% of AC patients. The most common form of treatment is surgery. Thirty-eight different immunohistochemical markers were evaluated in the studies. Ki-67 alone appeared more than in one study (5 studies). Ki-67 proliferation index was higher in AC than in benign ameloblastoma in all five studies. Conclusions: Ameloblastic carcinoma is a rare odontogenic tumor which occurs in adult people, most often in the mandible. One fifth of patients had metastases. According to the studies on Ki-67, Ki-67 could serve as a useful marker in distinguishing AC from ameloblastoma. This can be important, as distinguishing between benign and malignant ameloblastoma histopathologically is often difficult.