Ameloblastic Carcinoma: A Case Report and Comprehensive Review of a Rare Odontogenic Malignancy

Abstract

Background: Ameloblastic carcinoma (AC) is a rare odontogenic malignancy that combines histological features of ameloblastoma with malignant cytology. Its rarity and infiltrative nature pose challenges for diagnosis, treatment, and prognosis.

Case Presentation: A 34-year-old male presented with swelling in the left mandible. Imaging revealed a 3.8 × 2.7 × 7 cm expansile lytic lesion. Histopathology confirmed ameloblastic carcinoma with nests and sheets of malignant odontogenic epithelial cells, peripheral palisading, and atypical mitoses. Final excision revealed a positive superior mucosal margin and critically close margins at medial (0.3 cm), posterior (0.5 cm), and lateral (0.5 cm) soft tissues. Adjuvant radiotherapy (66 Gy with boost) was administered. At 6 months, the patient remained disease-free.

Conclusion: Adequate surgical margins remain the cornerstone of AC management. When margins are positive or close, adjuvant radiotherapy is essential for locoregional control. Advances in molecular oncology (e.g., BRAF-targeted therapy) may further transform future management.