Rais Rehan, El-Mofty Samir K
Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.
Head Neck Pathol. 2019 Dec;13(4):705-710. doi: 10.1007/s12105-018-0946-y. Epub 2018 Jul 4.
Ameloblastomas are the most common odontogenic tumors, excluding odontomas. Several morphologic variants have been described including follicular, plexiform, acanthomatous, granular cell, basaloid and desmoplastic. Desmoplastic ameloblastoma differs from other conventional ameloblastomas microscopically, clinically, and radiographically. Ameloblastic carcinoma, the malignant counterpart of ameloblastoma is characterized by cytologic features of malignancy combined within the overall histologic features of conventional ameloblastoma. Malignant transformation of ameloblastoma to squamous cell carcinoma is a controversial subject. Here we report a case of a desmoplastic ameloblastoma with malignant transformation to squamous cell carcinoma in a 49 year old African American man. The patient underwent tumor resection and radiation therapy with no evidence of disease recurrence or progression 16 months post operatively. To our knowledge malignant transformation of a desmoplastic ameloblastoma to squamous cell carcinoma has not so far been reported. This observation may lend some support to the argument that desmoplastic ameloblastoma is phenotypically and biologically distinct entity.
成釉细胞瘤是除牙瘤外最常见的牙源性肿瘤。已描述了几种形态学变异型，包括滤泡型、丛状型、棘皮瘤型、颗粒细胞型、基底细胞型和促结缔组织增生型。促结缔组织增生型成釉细胞瘤在显微镜下、临床和影像学上与其他传统成釉细胞瘤不同。成釉细胞癌是成釉细胞瘤的恶性对应物，其特征是在传统成釉细胞瘤的整体组织学特征中结合了恶性的细胞学特征。成釉细胞瘤向鳞状细胞癌的恶性转化是一个有争议的话题。在此，我们报告一例49岁非裔美国男性促结缔组织增生型成釉细胞瘤恶变至鳞状细胞癌的病例。患者接受了肿瘤切除和放射治疗，术后16个月无疾病复发或进展的证据。据我们所知，促结缔组织增生型成釉细胞瘤向鳞状细胞癌的恶性转化迄今为止尚未见报道。这一观察结果可能为促结缔组织增生型成釉细胞瘤在表型和生物学上是独特实体的观点提供一些支持。
