Niamat Ullah, Naveed Yousaf.
A Rare Case of Malignant Ameloblastoma with Multicentric Presentation.
J Coll Physicians Surg Pak Jan ;11(8):514-5.

Malignant ameloblastoma accounts for less than 1% tumour of the faciomaxillary region, arising from epithelial odontogenic cells or dental lamina. The commonest site is the ascending ramus of mandible and maxilla. A rare case of malignant ameloblastoma at unusual sites is reported. It is important to identify this condition to offer adequate excision and prevent recurrence. This is a case of 9 years old male child, who presented a mass in left cheek and inguinal mass with amputated right leg. Complete excision of the maxilla and inguinal mass was carried out and confirmed as a metastatic malignant ameloblastoma both in maxilla and inguinal region. There was recurrence of the same growth in the right maxilla and skull bones after one year. This is a unique presentation of ameloblastoma spreading to remote areas in the body that has not been reported in the literature.

A 9 years old male child was admitted in our ENT Department at Lady Reading Hospital, Peshawar on May-June 1998 with history of swelling left cheek and right inguinal mass. The cheek swelling appeared 10 months back and rapidly increased in size in the last 3 months. It was progressively pushing the left eye ball upward and medially with a proptosis and intact vision. There was history of nasal obstruction with blood stained nasal discharge. He had epiphora as well.

On physical examination patient revealed 8x9 cm irregular solid mass of the left cheek which totally occupied the left nasal cavity with protrusion of the lateral wall, left palate and alveolus resulting in loosening of teeth. The mass was smooth and non-tender. The local temperature over the mass was normal, the overlying skin was intact and freely mobile over the mass.

On systemic examination there was a mass 8x9 cm in the right inguinal region. The overlying tissue was normal, in the past patient suffered from the same lesion of the right lower limb which was amputated on October 10,1992. Mass from the right axilia was excised by the general surgeon and reported as adamantinoma on histopathology in November 13, 1996. The lesion of the left maxilla and right groin appeared during the last ten months

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