New classification of maxillary ameloblastic carcinoma based on an evidence-based literature review over the last 60 years.
BACKGROUND
The ameloblastic carcinoma is a rare malignant odontogenic tumor which rather occurs in the mandible than in the maxilla. Its rarity and in this context somewhat speculative histopathogenesis may account for diagnostic difficulties. Current classifications do not consider benign histopathological features at the primary and malignant features at the metastatic tumour site. Based on an evidence-based literature review, a recommendation for a novel classification is presented.


METHODS
An evidence-based literature review over the last 60 years regarding ameloblastic carcinoma of the maxilla was conducted.


RESULTS
An overall of 26 cases were found (mean age: 54.4 (583 years); male to female ratio: 2.7 to 1). In 54% the primary diagnosis was ameloblastic carcinoma, 34.6% revealed pulmonary metastases, however, only in one patient cervical lymph node metastasis could be found. Whereas two cases did not reveal malignant histopathology at the primary, they revealed malignant features at their metastatic sites. Nineteen of 26 patients (73,1%) were controlled during a median follow-up time of 54,3 months (6 to 156 months); 6 patients died of disease after a median time of 62,7 months (7 to 156 months) after initial diagnosis.


CONCLUSIONS
It is of utmost importance to be aware of that ameloblastomas may be capable to degenerate into a "malignant" disease with recurrence and metastasis. In addition to local long-term control, special attention should be paid to potential pulmonary involvement.
Kruse
Astrid L D
AL
Department of Craniomaxillofacial and Oral Surgery, University of Zurich, Zurich, Switzerland. astridkruse@gmx.ch
Zwahlen
Roger A
RA
Grätz
Klaus W
KW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000564:Ameloblastoma / Q000145:classification* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008441:Maxillary Neoplasms / Q000145:classification* / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local
Oral Surg Oral Med Oral Pathol. 1987 Nov;64(5):570-6
3313152
Eur J Cancer B Oral Oncol. 1995 Mar;31B(2):86-99
7633291
Pediatr Blood Cancer. 2008 Jan;50(1):175-6
16652346
Am J Clin Pathol. 1981 Apr;75(4):585-91
7223720
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Dec;104(6):e17-24
17942338
J Craniomaxillofac Surg. 2002 Oct;30(5):273-9
12377199
J Craniomaxillofac Surg. 1990 Aug;18(6):247-50
2212021
Ann Surg. 1948 Nov;128(5):999-1005
17859260
Ann Otol Rhinol Laryngol. 1983 Sep-Oct;92(5 Pt 1):532
6625456
J Craniofac Surg. 2004 Mar;15(2):264-9
15167247
Am J Clin Pathol. 1988 Oct;90(4):474-81
3052019
J Oral Maxillofac Surg. 2003 Jun;61(6):731-4
12796889
J Otolaryngol. 1989 Apr;18(3):109-11
2716084
Oral Surg Oral Med Oral Pathol. 1982 Sep;54(3):299-303
6957827
Diagn Cytopathol. 1996 May;14(3):249-52
8732656
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Jun;91(6):649-53
11402276
Laryngoscope. 2004 Oct;114(10):1770-4
15454770
Eur J Cancer B Oral Oncol. 1993 Jul;29B(3):169-71
8298419
J Oral Maxillofac Surg. 1993 Oct;51(10):1152-5; discussion 1156-7
8410456
Pathologe. 2008 May;29(3):214-20
18330573
J Laryngol Otol. 1995 Oct;109(10):1019-22
7499939
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Jun;103(6):799-807
17448710
Oral Surg Oral Med Oral Pathol. 1984 Feb;57(2):168-76
6366686
J Maxillofac Surg. 1986 Dec;14(6):338-40
3467002
J Oral Pathol Med. 1998 Jan;27(1):39-42
9466734
J Oral Med. 1986 Apr-Jun;41(2):79-81
3459830
J Can Dent Assoc. 2003 Oct;69(9):573-6
14653932
J Craniomaxillofac Surg. 1998 Jun;26(3):159-62
9702634
J Oral Maxillofac Surg. 2007 Apr;65(4):777-83
17368379
J Oral Maxillofac Surg. 2002 Jan;60(1):102-4
11757019
Oral Oncol. 2003 Oct;39(7):736-41
12907214
Bull Tokyo Dent Coll. 1972 May;13(2):91-101
4504978
J Oral Maxillofac Surg. 2007 Sep;65(9):1800-3
17719401
J Oral Surg. 1980 Mar;38(3):203-6
6928185
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Aug;88(2):170-6
10468461
Virchows Arch A Pathol Anat Histol. 1979 Feb 9;381(2):211-22
154765