Kosin Med J.  2022 Mar;37(1):83-88. 10.7180/kmj.21.030.

Metastatic ameloblastoma with postoperative accelerated tumor growth treated with carboplatin and paclitaxel: a case report

• Park JU
• Jung JW

• KMID: 2527699
• DOI: http://doi.org/10.7180/kmj.21.030

Abstract

Ameloblastoma is a histologically benign odontogenic epithelial tumor that rarely metastasizes. However, metastasis to the lungs can occur, usually years after the development of the primary tumor. Here, we present the case of a 63-year-old woman with metastatic ameloblastoma in the lungs that developed 12 years after surgery for the primary lesion. As is typical for metastatic ameloblastomas, the tumor was incidentally found on radiography and surgically removed. However, the tumor exhibited accelerated progression with pleural metastasis after surgical removal, which is unusual in metastatic ameloblastoma. The patient was successfully treated with carboplatin/paclitaxel and showed a partial response to tumor progression, implying that this approach can be safely used in the absence of a standard treatment regimen.

Keyword

Ameloblastoma; Case reports; Carboplatin; Neoplasm metastasis; Paclitaxel; Postoperative complication

Figure

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  Fig. 1. Initial chest computed tomography performed in October 2013. (A) A 13-mm heterogeneous enhancing solid nodule with a peripheral ground-glass opacity in the right lower lobe (arrow). (B) An 8-mm small, noncalcified nodule in the right middle lobe (arrow).

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  Fig. 2. Follow-up chest computed tomography performed in March 2020. (A) A 45-mm well-defined, lobulated, heterogeneously enhancing mass with a peripheral ground-glass opacity, abutting the right major fissure and diaphragm and causing pleural retraction in the right lower lobe (arrow). (B) A 14-mm, spiculated-margin, enhancing solid nodule with pleural retraction in the right middle lobe (arrow).

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  Fig. 3. Pathological findings of the lung biopsy specimen. (A) The pulmonary metastatic lesion is more cellular, with a clear margin between the lesion and the surrounding lung tissue (H&E, ×40). (B) Anastomosing epithelial strands show peripheral palisading (arrows) with more loosely arranged angular cells (arrowheads) and variable keratinization (asterisk) (H&E, ×100). (C) CD56 is preferentially expressed in peripheral cells, and (D) CK19 is expressed in all cells (immunohistochemical stain, ×100).

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  Fig. 4. (A) Chest computed tomography performed in July 2020. Newly developed multifocal enhancing pleural and fissural nodules in the right hemithorax (arrows). (B) Follow-up chest computed tomography performed after chemotherapy, showing markedly decreased size of the previously noted pleural and fissural nodules in the right hemithorax (arrows).

Reference

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