Unveiling the Enigma: A Case Report of Ameloblastic Carcinoma with Surgical Management and Clinical Insights

Ameloblastic carcinoma is a rare malignant epithelial odontogenic tumor. It represents approximately 1% of all oral malignancies. The lower jaw is the most common site for the development of ameloblastic carcinoma. Most commonly presents with progressive pain, swelling of the jaw, bleeding, and headache. The most common course of the disease is persistent recurrence with local spread and the most common site of metastases is the lungs. A 69-year-old male presented with a 2–3-year history of swelling on the left mandibula, which progressively increased in size in the 3 months before presentation. On examination of the oral cavity, an exophytic mass centered on the left angle and body of mandible was present. A cystic osseous mass was identified on computed tomography. Incisional biopsy was done. Histomorphology was consistent for ameloblastic carcinoma. He underwent a left segmental mandibulectomy with a left fibular free flap, left neck dissection levels I–II, and a tracheostomy. Histopathology confirmed the diagnosis of ameloblastic carcinoma. The work has been reported in line with the SCARE criteria30. Ameloblastic carcinoma is an ameloblastoma with a malignant morphologic appearance, regardless of the presence of metastasis. It is an extremely rare malignant odontogenic epithelial neoplasm and may arise de novo or from a preexisting odontogenic lesion. En bloc resection is the treatment of choice. The role of radiotherapy is controversial, and chemotherapy may be used in the presence of metastasis. Ameloblastic carcinomas can recur locally or present with metastasis after definitive therapy. Ameloblastic carcinoma is a rare malignant tumor. Clinical evaluation, appropriate imaging, and biopsy are required to make a diagnosis. Surgical excision is the treatment of choice.