J Korean Assoc Oral Maxillofac Surg.  2015 Jun;41(3):139-144. 10.5125/jkaoms.2015.41.3.139.

Odontogenic carcinosarcoma of the mandible: a case report and review

• Kim IK
• Pae SP
• Cho HY
• Cho HW
• Seo JH
• Lee DH
• Park IS

• KMID: 1797844
• DOI: http://doi.org/10.5125/jkaoms.2015.41.3.139

Abstract

Odontogenic carcinosarcoma is an extremely rare malignant odontogenic tumor with only a few reported cases. It is characterized by a true mixed tumor showing malignant cytology of both epithelial and mesenchymal components. It has been assumed to arise from pre-existing lesions such as ameloblastoma, ameloblastic fibroma, and ameloblastic fibrosarcoma. To date, the reported cases have exhibited considerably aggressive clinical behavior. The case of an odontogenic carcinosarcoma in the mandible of a 61-year-old male is described herein. The tumor destroyed the cortex of the mandible and invaded the adjacent tissues. Treatment was performed by surgical resection and reconstruction. The purposes of this article are to introduce odontogenic carcinosarcoma through this case study, to distinguish it from related diseases and to discuss features of the tumor in the existing literature.

Keyword

Carcinosarcoma; Mixed tumor; Ameloblastoma; Fibrosarcoma; Odontogenic tumor

MeSH Terms

Ameloblastoma
Ameloblasts
Carcinosarcoma*
Fibroma
Fibrosarcoma
Humans
Male
Mandible*
Middle Aged
Odontogenic Tumors

Figure

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  Fig. 1 Panoramic view shows radiolucent lesion of the left mandible.

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  Fig. 2 Computed tomography shows an osteolytic mass with destruction of the inner cortex in the angle of the left mandible, involving the periapical area of the left 2nd molar tooth and left alveolar canal. A. Coronal view. B. Axial view. C. Three-dimensional image view.

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  Fig. 3 Magnetic resonance imaging shows 2.2×2.8×4.1 cm sized osteolyitc enhancing mass in the angle of the left mandible with invasion of the adjacent mandible bone marrow, surrounding tissue, and masseter muscle. A. Coronal view. B. Axial view.

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  Fig. 4 Histopathologic image of the tibial lesion (H&E staining, ×200).

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  Fig. 5 Excised mass with 3.5×3.4×2.5 cm size which included tumor, mandible, and regional lymph node.

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  Fig. 6 A. Postoperative (1 month) panoramic view. B. Final postoperative (6 months) panoramic view after plate removal.

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  Fig. 7 A. Malignant epithelial component with pleomorphism, enlarged and atypical nuclei (H&E staining, ×400). B. Malignant mesenchymal component with hypercellularity, pleomorphism, enlarged and atypical nuclei (H&E staining, ×400).

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  Fig. 8 Immunohistochemical stain images (×400). A. Malignant epithelial component. Intense membranous and cytoplasmic staining for cytokeratin. B. Positive staining for CAM 5.2 antigen supporting the diagnosis of malignancy. C. Malignant mesenchymal component showing positivity for vimentin.

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