AMELOBLASTOMA OF MANDIBLE WITH PULMONARY METASTASIS

An unusual case of histologically proven pulmonary metastasis from a mandibular ameloblastoma has been presented. Although many cases of primary ameloblastoma have been reported, pulmonary metastasis is quite rare. Only four prior authentic cases have been reported. The mechanism of spread appears to be via three possible routes: vascular, lymphatic, or directly down the respiratory passages. From the prior cases one can conclude that a patient with multiple recurrences and excisions is more likely to have metastasis. The present case is unusual because of the very short time between onset of the tumor and metastasis, and the lack of multiple procedures. At the time of pulmonary metastasis there was no evidence of local recurrence. Possibly, if an adequate radical excision had been done initially, the subsequent metastasis might not have occurred. The authors stress that the malignant potential of ameloblastomas should be recognized and adequate en bloc resection provided at the time of initial treatment. Local curettage is to be avoided as this predisposes to recurrences, widespread extension and the possibility of metastasis. © 1969, SAGE Publications. All rights reserved.