Simko E J, Brannon R B, Eibling D E
Otolaryngology Service, Langley Air Force Base, VA, USA.
Head Neck. 1998 Oct;20(7):654-9. doi: 10.1002/(sici)1097-0347(199810)20:7<654::aid-hed14>3.0.co;2-4.
Ameloblastic carcinoma is a rare, aggressive odontogenic neoplasm of the jaws in which the epithelial cells exhibit cytologic features of recognizable ameloblastoma and malignancy. Cases with metastasis have been infrequently reported.
A case of a 64-year-old white woman with mandibular ameloblastic carcinoma with documented distant metastasis is presented. The patient's presenting symptoms included facial asymmetry of the right jaw over 2 months and the development of moderate trismus. Clinical manifestations, pathology, treatment, and biologic behavior are discussed. The nomenclature and classification of odontogenic carcinomas are reviewed, including entities that should be considered in the differential diagnosis.
The patient underwent surgical resection consisting of mandibulectomy, parotidectomy, and modified radical neck dissection followed by radiation to both necks and tumor bed. Postsurgically, the patient developed pulmonary metastasis at 11 months and expired with widespread metastatic disease at 28 months.
This case demonstrated an unusual behavior pattern in that local recurrence and regional metastasis did not occur. Distant metastasis occurred despite apparent adequate control of the primary mandibular tumor. The ameloblastic carcinoma is a highly malignant neoplasm which requires aggressive therapy. Prognosis is poor. Further reporting of ameloblastic carcinoma is encouraged.
成釉细胞癌是一种罕见的、侵袭性的颌骨牙源性肿瘤，其中上皮细胞表现出可识别的成釉细胞瘤的细胞学特征和恶性特征。有转移的病例报道较少。
报告一例64岁白人女性下颌成釉细胞癌伴远处转移的病例。患者的主要症状包括右颌面部不对称超过2个月以及中度牙关紧闭。讨论了临床表现、病理、治疗和生物学行为。回顾了牙源性癌的命名和分类，包括鉴别诊断中应考虑的实体。
患者接受了包括下颌骨切除术、腮腺切除术和改良根治性颈清扫术在内的手术切除，随后对双侧颈部和肿瘤床进行放疗。术后，患者在11个月时出现肺转移，并在28个月时因广泛转移疾病死亡。
该病例表现出一种不寻常的行为模式，即未发生局部复发和区域转移。尽管对原发性下颌肿瘤进行了明显充分的控制，但仍发生了远处转移。成釉细胞癌是一种高度恶性肿瘤，需要积极治疗。预后较差。鼓励进一步报告成釉细胞癌。
