John Sharon, Ramya S, Verma Saloni, Samadi Fahad M, Gupta Shalini
Department of Oral Pathology, King George's Medical University, Lucknow, UP 226003 India.
Department of Oral and Maxillofacial Pathology, King George's Medical University, Lucknow, UP 226003 India.
Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):1229-1233. doi: 10.1007/s12070-023-04232-z. Epub 2023 Oct 1.
Ameloblastic carcinoma is a rare malignant neoplasm with characteristic histopathological features that are directed towards an aggressive surgical approach than benign odontogenic lesions. It affects people of all ages, mostly in the posterior mandible, without a preference for race or gender. De novo cancer is one of its primary types, while the second type is defined as a malignant change from an antecedent case of benign ameloblastoma. The rapid progression of molecular biology led to the revelation that ameloblastoma contains a BRAF-V600E genetic mutation over 60%. Besides conventional ameloblastic carcinomas, rare histologic variants have also been described in the literature, including clear and spindle cells. These variants pose diagnostic challenges as to whether it is a dedifferentiation or a distinct entity. The dearth of data lends credence to the notion that these histologic variations are related to high-grade neoplasms and more aggressive outcomes. As a result, the current report intends to analyze a series of patients diagnosed with conventional ameloblastic carcinoma of the head and neck region with spindle and clear cell types along with a brief assessment of the literature.
成釉细胞癌是一种罕见的恶性肿瘤，具有独特的组织病理学特征，与良性牙源性病变相比，需要采取更积极的手术方法。它可发生于各年龄段人群，多累及下颌后部，无种族或性别倾向。原发性癌是其主要类型之一，第二种类型定义为由先前的良性成釉细胞瘤恶变而来。分子生物学的快速发展揭示，超过60%的成釉细胞瘤存在BRAF-V600E基因突变。除了传统的成釉细胞癌，文献中还描述了罕见的组织学变异型，包括透明细胞型和梭形细胞型。这些变异型在诊断上存在挑战，即难以判断其是去分化型还是独立的实体。数据的匮乏支持了这样一种观点，即这些组织学变异与高级别肿瘤及更具侵袭性的预后相关。因此，本报告旨在分析一系列诊断为头颈部传统型成釉细胞癌的梭形细胞型和透明细胞型患者，并对相关文献进行简要评估。
