Ameloblastoma is an odontogenic tumor characterized by various sites of metastasis, malignant transformation, and a high recurrence rate over time. Ameloblastic carcinoma(AC) is the term reserved for an ameloblastoma with histologic evidence of malignancy in the primary tumor. AC is classified into two types: most ACs occur de novo, and only few cases of malignant transformation of ameloblastoma become apparent. Here, we report a case of AC, arising from recurrent acanthomatous ameloblastoma on the maxillary sinus, in a 60-year-old male patient. The mass was first diagnosed as acanthomatous ameloblastoma; subsequently, surgical curettage was performed thrice while partial maxillectomy was performed twice. On the fifth recurrence, the tumor was identified as AC.

Angiogenesis is a process with a coordinated sequence of endothelial cell division, selective degradation of vascular basement membranes, and surrounding extracellular matrix with migration of theses cells that result in a new capillary growth from preexisting vessels. These processes are controlled by numerous different molecules. Among these, Vascular Endothelial Growth Factor(VEGF) is an endothelial cell-specific mitogen with a potent ability to induce microvessel permeability and angiogenesis. In this study, tissue samples of odontogenic keratocyst(10 cases), ameloblastoma(10 cases), adenomatoid odontogenic tumor(10 cases), calcifying epithelial odontogenic tumor(10 cases), ameloblastic carcinoma(2 cases) were obtained, and all specimen were routinely fixed in 10% formalin and embedded. Serial 5μm thick sections were cut from paraffin blocks. And the immunohistochemical staining, characteristics of VEGF about the cyst & tumor were observed & obtaned the results from this study. We presume that the growth of cyst is depends on not a differentiation but an epithelium & connective tissue. But, in odontogenic tumor, we presumed that the growth of tumor is influenced on inflammation & surrounding stimulus & vascular growth and supply. Therefore, it should be suggested that study on the growth of tumor and vascularity must be carrying out in this immunohistochemical study.

Amelobl astic carcinoma(AC) is a maJignant coun terpart of ameloblastoma. histologically characteri zed by amelobJastomatolls feature with obviollS cytologic a typi a . AC is a r are malignant tumor with poten t iaJ of metastasis‘ asssllmed to occur far less tha n 1% of ameloblastoma . Nearly 80% of ACs have been reported to occur in the mandibJ e. The allthors reviewed 5 cases of AC in Department of Oral PathoJogy. SeouJ National University from 2005 to 2007 clini copathologically according to age, sex. location and clinical findings. They occllrred at the age from 46 to 75 years wi th average age of 60 Four cases occurred in male and 1 in female‘ showing prediJ ection for ma le‘ While four cases occu rred in the maxilla , including 3 cases in the maxillary molar area and 1 in the maxiJJ a ry premola l‘ a rea, only 1 case occurred in the mandibJe. AC showing predorninance in the maxilla over t he ma ndible in our cases in contrast to other case reviews. Three patients presented painful large oral lllcer at the time of admi ssion, a nd other 2 patients presented swol1en mass around the gingivae and alveoJar bone While the clini cal impression of 3 patients were ma lignant tllmor, other 2 patients were amelboJastoma and nicotine stomatitis. The dllration of symptoms before final diagnosis has ranged from 4 months to 2 years Radiogr a phicalJy they showed poorly demarcated radiolucent lesion with irreg비 ar bony destruction. Resected tumors were measured as 6.0X4.5x4.0cm‘ 0‘ 7xO.5xO.3cm, 5.0 x 4.5 X5.0cm. 0.8xO.6 XO.5cm, and 5cm diametel mass respecti vely. Microscopically lymph node metastasis was confirmed in 1 case, but not in others . The tumors showed basic histologic featu re of ameloblastoma with apparent cytologic atypia sllch as pleomol‘ phism‘ hyper chromatism and atypical ffiJ tOSIS Individua l neoplastic cells displayed wide va riations from case to case‘ showing c lear cells with faint PAS positive granules‘ isolated round cells with abundant cytoplasm. s quamoid ceJls and polygonaJ cell s . [mmunohis toc hemical survey was done in 2 cases. all of which showed positivity to pan-cytoker atin a ntibody and p53 a ntibody‘ but negativity to HMB-45, S-100, and SMA One case recurred twice during 2 yeal's after surgery. But 3 cases showed no evidence of recurrence and metastas is. lt seems to us t hat AC have the potential of metastasis and reCllrrence.

Ameloblastic carcinoma is an ameloblastoma wi th histological malignant transformation with 01' without metastatic di sease_ We report an ameloblastic carcinoma ex ameloblastoma of right mandibular body in 7 -year-old girl with a heterogeneo us hi stologic components_ The tumor s howed so lid s heets composed of atypical kerati nized squamous cells. small ovoid cell s. and s pind le cells in addi tion to a bit of beni gn ameloblastoma component_ Immunohis tochemically, the squ amous cells were strongly cytokemtin posi ti ve/vimentin negati ve and the small ovoid and spindle ce lls were weakJy cytokeratin positi ve/v imentin pos it ive_