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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
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Year : 2012  |  Volume : 16  |  Issue : 1  |  Page : 156-158
 

Ameloblastic carcinoma: Sometimes a challenge


Department of Oral Pathology and Microbiology, Gitam Dental College and Hospital, Gandhinagar Campus, Rushikonda, Vishakapatanam, India

Date of Web Publication17-Feb-2012

Correspondence Address:
Samapika Routray
Department of Oral Pathology and Microbiology, Gitam Dental College and Hospital, Gandhinagar Campus, Rushikonda, Vishakapatanam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-029X.92998

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How to cite this article:
Routray S, Majumdar S. Ameloblastic carcinoma: Sometimes a challenge. J Oral Maxillofac Pathol 2012;16:156-8

How to cite this URL:
Routray S, Majumdar S. Ameloblastic carcinoma: Sometimes a challenge. J Oral Maxillofac Pathol [serial online] 2012 [cited 2019 Sep 18];16:156-8. Available from: http://www.jomfp.in/text.asp?2012/16/1/156/92998


A 60-year-old male reported with pain and extraoral swelling in the left lower third of the face. Clinically, a 2 cm × 2 cm bony hard swelling was seen extending up to the left angle of the mandible. The swelling was tender on palpation, with no signs of parasthesia. Intraorally, the ulcer was 1 cm × 3 cm in size and showed white slough and and an indurated border. Radiographically, a diffuse radiolucency was seen.


   Histopathology Top


  • Ulcerated mucosal surface with acute inflammation is seen, along with pleomorphic epithelial cells irregularly arranged in cords and nests [Figure 1] and [Figure 2].
  • Figure 1: Section showing ulcerated mucosa, lymphocytic infiltration, and tall columnar cells (H and E, ×4)

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    Figure 2: Section showing ulcerated mucosa, lymphocytic infiltration, and tall columnar cells (H and E, ×4)

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  • Moderate acute inflammation with keratotic debris is seen in the islands lined by tall columnar cells showing nuclear atypia and mitotic activity [Figure 3],[Figure 4],[Figure 5],[Figure 6] and [Figure 7].
  • Figure 3: Sections showing keratotic debris and islands of tall columnar cells with pleomorphism (H and E, ×10)

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    Figure 4: Sections showing keratotic debris and islands of tall columnar cells with pleomorphism (H and E, ×10)

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    Figure 5: Sections showing keratotic debris and islands of tall columnar cells with pleomorphism (H and E, ×10)

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    Figure 6: Sections showing keratotic debris and islands of tall columnar cells with pleomorphism (H and E, ×10)

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    Figure 7: Sections showing keratotic debris and islands of tall columnar cells with pleomorphism (H and E, ×10)

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  • Intervening stroma is vascular and shows dense lymphocytic infiltration.
  • The islands of tall columnar cells show a high degree of pleomormhism and mitotic activity; the intervening stroma is vascular [Figure 8],[Figure 9],[Figure 10],[Figure 11],[Figure 12] and [Figure 13].
  • Figure 8: Sections showing islands of tall columnar cells with pleomorphism, nuclear atypia, and mitotic activity; the intervening stroma is vascular (H and E, ×40)

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    Figure 9: Sections showing islands of tall columnar cells with pleomorphism, nuclear atypia, and mitotic activity; the intervening stroma is vascular (H and E, ×40)

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    Figure 10: Sections showing islands of tall columnar cells with pleomorphism, nuclear atypia, and mitotic activity; the intervening stroma is vascular (H and E, ×40)

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    Figure 11: Sections showing islands of tall columnar cells with pleomorphism, nuclear atypia, and mitotic activity; the intervening stroma is vascular (H and E, ×40)

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    Figure 12: Sections showing islands of tall columnar cells with pleomorphism, nuclear atypia, and mitotic activity; the intervening stroma is vascular (H and E, ×40)

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    Figure 13: Sections showing islands of tall columnar cells with pleomorphism, nuclear atypia, and mitotic activity; the intervening stroma is vascular (H and E, ×40)

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   Differential Diagnosis Top


Conventional ameloblastoma does not show the same intensity of pleomorphism, whereas squamous differentiation in ameloblastoma resembling keratotic debris might be confused with squamous cell carcinoma.


   Final Diagnosis Top


The histopathological features are suggestive of ameloblastic carcinoma.


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12], [Figure 13]



 

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