Metastasizing ameloblastoma: a systematic review in search of clinicopathological predictors

Abstract

Introduction: Ameloblastoma is a benign odontogenic tumor that is aggressive and localised in nature, listed as the first or second most prevalent odontogenic tumor and rarely tends to metastasis, but when it does, it receives the definition adopted by the WHO in 2017 of metastasizing ameloblastoma. Materials and Methods: This systematic review of clinical case reports of metastasizing ameloblastoma from the last 10 years, collected from PubMed, ScienceDirect and Cochrane digital databases, aims to search for association between clinical/pathological and/or molecular parameters of ameloblastoma and its metastatic potential. Results: The targeted search yielded 14 publications with a total of 18 clinical cases, which showed a mean age for diagnosis of metastasizing ameloblastoma of 46 years, with no gender predilection and a high probability of occurrence in the yellow Asian race, favouring a pattern of distant dissemination. The highest frequency of metastasis was associated with mandibular primary lesions diagnosed in young patients, and the most frequently found variant was the multicystic solid type, follicular subtype; distant metastasis was the predominant form of presentation, with the lungs being the main target. Conclusion: At the moment, there is nothing that can predict metastatic potential in ameloblastoma. More standardised studies exploring the molecular terrain are needed, as this is a key and understudied factor.