The diagnosis of ameloblastic carcinoma is usually based on an assessment of a constellation of histologic findings.
The diagnosis of ameloblastic carcinoma is based on the worst appearing area in the tumor, since foci of the tumor may resemble an ameloblastoma.
Features which should prompt an evaluation for ameloblastic carcinoma:
(1) sheets of cells
(2) islands of cells
(3) trabeculae of cells
(4) absence of stellate reticulum-like areas
Histologic features may include:
(1) nuclear hyperchromatism
(2) large and/or atypical nuclei
(3) increased mitotic index
(4) tumor necrosis
(5) calcification
(6) neural and vascular invasion
(7) clear cells representing > 15% of tumor cells
Additional factors:
(1) presence of metastases
Early, aggressive and complete removal of the tumor offers the best chance of survival. Inadequate initial management results in multiple recurrences and eventual death.
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