Malignant ameloblastoma or ameloblastic carcinoma

Area of Science:

• Oral pathology
• Oncology

Background:

• The World Health Organization (WHO) defines malignant ameloblastoma based on ameloblastic features in primary and metastatic growths.
• Current diagnostic criteria may lead to indiscriminate classification of lesions with varied behaviors.

Observation:

• This study adds two cases of ameloblastoma with malignant behavior to existing literature.
• The diagnosis of "malignant ameloblastoma" is applied inconsistently, grouping histologically diverse lesions.

Findings:

• The WHO classification's emphasis on metastasis, with vague histopathologic definitions, contributes to diagnostic ambiguity.
• A proposed revision suggests reserving "malignant ameloblastoma" for histologically benign-appearing metastatic lesions.

Implications:

• The study advocates for modifying the WHO classification to include "ameloblastic carcinoma" for less-differentiated ameloblastomas with malignant features.
• Refined terminology will improve diagnostic accuracy and understanding of ameloblastoma's malignant potential.