ODONTOGENIC MALIGNANCIES

OBJECTIVES

 Tounderstand the pathogenesis,

etiology and histopathology of
odontogenic malignancies.

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Ameloblastic Carcinoma

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Malignant ameloblastoma and
ameloblastic carcinoma

 Malignant behaviour in ameloblastoma 

1%

 Age  4-75 years

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 Matastases
 Lung
 Cervical lymph nodes
 Vertebrae
 Bones
 viscera

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 Histopathological findings
 Malignant ameloblastoma  same as non-
metastasizing ameloblastoma

 Ameloblastic carcinoma  cytologic atypia

▪ ↑ N/C ratio
▪ Nuclear hyperchromatism
▪ Presence of mitosis
▪ Necrosis in tumor islands
▪ Areas of dystrophic calcifications

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 Treatment of Ameloblastoma

According to growth characteristics and type

 Unicystic
 Complete removal
 Peripheral osteoctomies if extension through
cyst wall
 Conventional/ aggressive
 Mandibular – adequate normal bone around
margins of resection
 Maxillary – more aggressive surgery, 1.5 cm
margins
 Ameloblastic carcinoma
 Radical surgical resection (like SCCa)
 Neck dissection for LAN
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Ameloblastic fibrosarcoma

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 Malignant counterpart of ameloblastic
fibroma

 Mayarise de novo or malignant

transformation of ameloblastic fibroma

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Clinical features
 Young patients
 Females (1.5:1)
 Mandible > maxilla
 Pain, swelling
 Rapid growth
 Destruction of bone and loosening of teeth
 Ulceration and bleeding

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Radiographic features

 Unilocular or multilocular radiolucency

 Severe bone destruction

 Poorly defined margins

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Histopathological features
 No apparent change in odontogenic epithelium
 Less prominent

 Mesenchymal component
 Highly cellular
 Hyperchromatism and pleomorphism
 Mitosis is prominent

 Dysplastic dentin or small amounts of enamel may be

formed

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Treatment and prognosis

 Radical surgical excision

 High recurrence rate

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Commonly asked questions

 Shortnotes on Odontogenic
Malignanciies
References

Shafer, Hine,Levi. Textbook of Oral

Pathology; 5th Edition; Saunders
Publications.
Neville BW, Damm DD, Allen CM,
Bouquot JE. Oral & Maxillofacial
pathology. Second ed, W.B Sounders
Company, 2002