A Case of Mandibular Ameloblastoma With Pulmonary Metastasis 31years After Resection ~Comparing Pathological Images Original And Metastatic Lesions ~
~comparing pathological images original and metastatic lesions~
1) JUNKO YOSHIDA, YUICHIRO TAKAKU, CHIHARU NAGATSUKA, YOSHINORI IDE, and YUJI ICHIKAWA
2) MIE TASHIRO
1) Department of Dentistry and Oral Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Toshima Hospital ,Itabashi-ku, Tokyo, Japan
2) Showa University School of Dentistry, Oota-ku, Tokyo, Japan
<Abstract>
Background: Ameloblastoma is one of the common odontogenic tumors.
About 1% of ameloblastoma spread to other organs, and is called metastatic ameloblastoma. In the recent WHO classification, they define metastasis (malignant) ameloblastoma is a ne0-plasm in which the features of ameloblastoma exist in the primary tumor and in the metastatic tumor. We present here a case of mandibular ameloblastoma with pulmonary metastasis 31years after primary tumor resection.
Case: The patient was a 78-year-old male. At 47 years old, he underwent resection of the left mandibular ameloblastoma and his iliac bone grafted in there.
In February 2013, he was referred to our hospital (internal clinic) because of a chest abnormal shadow. The chest CT showed multiple nodules with spiculation and irregular shadow in both lungs. Suspected of lung cancer, he underwent transbronchial lung biopsy. The pathological diagnosis was metastatic ameloblastoma. In May 2013, he was referred to our hospital (dental clinic) for scrutiny of local recurrence. There is no abnormal finding upon intraoral examination and X-ray. Pathological images of the primary tumor showed follicular type ameloblastoma and pathological images of metastasis tumor showed the plexiform type ameloblastoma.
Conclusion: We report a case of mandibular ameloblastoma with multiple lung metastases that occurred 31years after initial surgery. Cases of metastatic ameloblastoma without local recurrence are rare in literature, and cases comparing pathologic images of the primary tumor and the metastatic tumor are rarer.
References:
1) Ikemura K, Tashiro H, Fujino D, et al : Ameloblastoma of the mandible with metastasis to the lungs and lymph nodes. Cancer 29 : 930-940, 1972
2) Morita S, Arika T, Nakajima M, et al : A malignant ameloblastoma of maxilla with pulmonary metastasis. Jpn. J. Oral Maxillofac. Surg. 33(8), 1529-1540, 1987
3) Kunze, E., Donath, K., et al: Biology of metastasizing ameloblastoma. Path Res Pract 180: 526-535 1985