Malignant odontogenic tumors

Malignant odontogenic tumors Classification Odontogenic carcinoma Malignant ameloblastoma. Ameloblastic carcinoma. Primary intraosseous carcinoma. Clear cell odontogenic carcinoma. Malignant counterpart of other od.tumors. Malignant changes in odntogenic cysts epithelial rests.

Malignant odontogenic tumors Odontogenic sarcoma: Ameloblastic fibrosarcoma. Ameloblastic fibro-odontosarcoma. Odontogenic carcinosarcoma.

Malignant ameloblastoma metastasizing ameloblastoma Defenition It’s aneoplasm that both primary and metastatic deposite show histopathology of ameloblastoma.

Malignant ameloblastoma metastasizing ameloblastoma Clinical features : Realative frequency 1% of all ameloblastoma Age :30 years Duration of metastasis appearance range between 1-30years Common metastatic sites: lungs 75% , cervical lymph nodes –vertebrea.

Malignant ameloblastoma metastasizing ameloblastoma X –ray : Similar to conventional ameloblastoma .

Malignant ameloblastoma metastasizing ameloblastoma Treatment : Excision of primary and secondary lesions Radiotherapy for in operable secendary lesions

Ameloblastic carcinoma Defenition : It’s an ameloblastoma that show cytological feature of malignancy that may later metastasis

Ameloblastic carcinoma Clinical features : Pain full and rapid growing swelling extending to involve adjecent soft tissues Metastatic lesions resemble squamous cell carcinoma Site : mandible Most died two years after metastasis Poor prognosis

Ameloblastic carcinoma X –ray : Ill defiend radiolucency with root resorption buccal perforation .

Ameloblastic carcinoma Treatment According to clinical stage .

Clear cell odontogenic carcinoma Clinical features : Origin :glycogen rich presecretory ameloblast Age : above 50 years Sites :both jaws Painfull swelling or asymptomatic lesion metastasize to the lungs ,cervical lymph nodes

Clear cell odontogenic carcinoma X –ray : Multilocular radiolucency with ill defiend margin .

Clear cell odontogenic carcinoma Histopathology : Nests and strands of epithelial cells with clear or faint eosinophilic cytoplasm hylainzation of connective tissue septa .

Clear cell odontoge nic carcinoma Clear cell odontoge nic carcinoma. Tumor island demonstrating cells with a clear cytoplasm. Note the peripheral columnar differentiation.

Clear cell odontogenic carcinoma Differential diagnosis : Clear cell renal carcinoma . Clear cell carcinoma of salivary gland

Clear cell odontogenic carcinoma Treatment according to the stage .

Ameloblastic fibrosarcoma ameloblastic fibrosarcoma is considered to be the malignant counterpart of the ameloblastic fibroma

Ameloblastic fibrosarcoma Clinical features : Site :mandible : maxilla ratio 2 :1 Age : wide range 13 -78 years mean age 26 50% risen from ameloblastic fibroma rapid growing with pain and swelling aggressive lesion that rarely metastasize .

Ameloblastic fibrosarcoma X –ray : ill defiend radiolucency moth eaten appearance

Ameloblastic fibrosarcoma Histopathology : Similar to ameloblastic fibroma with highly cellular and pleomorphic fibrous tissue . Dental tissue may present (dentine , enamel ) have been called ameloblastic dentino sarcomas or ameloblastic fibro odontosarcomas .

Ameloblastic fibrosarcoma Ameloblastic fibrosarcoma. The cellular mesenchymal tissue shows hyperchromatism and atypical cells. asmall island of ameloblastic epithelium is present

Ameloblastic fibrosarcoma Treatment and Prognosis Once the diagnosis of ameloblastic fibrosarcoma has been confirmed. radical surgical excision appears to be the treatment of choice. Curettage or local excision is usually followed by rapid local recurrence. The tumor is locally aggressive and infiltrates adjacent bone and soft tissues.