Peripheral ameloblastoma with cervical lymph node metastasis: a case report and review of the literature

This report describes a case of peripheral ameloblastoma of the mandible with metastasis to a cervical lymph node. The clinicopathological characteristics of both the primary and metastatic tumours are presented. In addition, a comprehensive review of the literature pertaining to this rare phenomenon was performed, covering the past 50 years. A 76-year-old male, who had undergone successful surgical resection of a right mandibular peripheral ameloblastoma 10 years earlier, presented with metastatic lesions in a cervical lymph node. Both the primary lesion and the metastatic specimen were re-examined using haematoxylin-eosin staining and immunohistochemical methods. Pathological examination revealed that both the primary and metastatic lesions were cytologically benign. The literature search identified 207 articles, among which 59 reported cases of ameloblastoma with metastasis. All reported cases involved intraosseous ameloblastoma, with the exception of one case of peripheral ameloblastoma reported in 1987. The diagnosis in such cases is often challenging due to the presence of multiple lesions. Both haematogenous and lymphatic metastases may occur, particularly in cases with multiple local recurrences and surgical interventions. In summary, metastatic ameloblastoma is very rare, and peripheral ameloblastoma with lymph node metastasis is even more uncommon, especially after successful surgery for the primary lesion.