Metastatic pulmonary ameloblastoma. An unusual case

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Ameloblastoma is a rare odontogenic tumor, typically benign but with potential for recurrence and metastasis.
• Metastatic ameloblastoma to the lungs is exceptionally uncommon, posing diagnostic and therapeutic challenges.

Observation:

• A patient presented with a large pulmonary metastasis 25 years post-jaw ameloblastoma resection.
• Fine needle aspiration posed diagnostic difficulties for pulmonary metastases.
• Radiological improvement was observed after a 5-year course of oral cyclophosphamide.

Findings:

• Histopathological diagnosis of pulmonary ameloblastoma metastases can be challenging.
• Chemotherapy, specifically oral cyclophosphamide, may induce radiological improvement in metastatic ameloblastoma.
• Resection of large pulmonary metastases, especially when adherent to the mediastinum, presents significant technical difficulties.

Implications:

• This case underscores the importance of long-term surveillance for patients with a history of ameloblastoma.
• It highlights the need for advanced diagnostic techniques and multidisciplinary approaches in managing rare metastatic tumors.
• The findings suggest a potential role for chemotherapy in specific cases and emphasize the complexity of surgical intervention for pulmonary metastases.