Malignant odontogenic tumors

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: Ameloblasticfibrosarcoma. Ameloblastic fibro-odontosarcoma. Odontogeniccarcinosarcoma.

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

5. Malignant ameloblastomametastasizing 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 ameloblastomametastasizing ameloblastoma X –ray : • Similar to conventional ameloblastoma .

7. Malignant ameloblastomametastasizing 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 defiendradiolucency with root resorptionbuccal perforation .

14. Ameloblastic carcinoma Treatment • According to clinical stage .

15. Clear cell odontogenic carcinoma Clinical features : • Origin :glycogen rich presecretoryameloblast • 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 : • Multilocularradiolucency 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 odontogenic 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. Ameloblasticfibrosarcoma • ameloblasticfibrosarcoma is considered to be the malignant counterpart of the ameloblasticfibroma

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

24. Ameloblasticfibrosarcoma X –ray : ill defiendradiolucency moth eaten appearance

26. Ameloblasticfibrosarcoma Histopathology : • Similar to ameloblasticfibroma with highly cellular and pleomorphic fibrous tissue . • Dental tissue may present (dentine , enamel ) have been called ameloblasticdentino sarcomas or ameloblastic fibro odontosarcomas .

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

28. Ameloblasticfibrosarcoma Treatment and Prognosis • Once the diagnosis of ameloblasticfibrosarcoma 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.