1. Malignant odontogenic tumors

2. 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.

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

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

5. 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.

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

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

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

9. 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

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

14. Ameloblastic carcinoma
Treatment
According to clinical stage .

15. 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

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

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

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

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

21. Clear cell odontogenic carcinoma
Treatment
according to the stage .

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

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

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

26. 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 .

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

28. 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.