Cancerization of Ameloblastoma in Free Fibula Neomandible

Ameloblastic carcinoma is an uncommon malignancy, it could be a primary or a malignancy developing secondary to an ameloblastoma. This malignancy has the potential for both hematogenous and lymphatic spread.

In this case report, we present a young man who was operated for a left-side ameloblastoma involving his hemimandible. The young man was treated with left hemimandibulectomy and reconstructed with a free fibula flap. Patient was doing well for almost two years but developed a swelling again, which indicated a recurrence as confirmed by fine-needle aspiration, but there was erosion of the neomandible. The lesion was again resected but post-operative biopsy showed ameloblastic carcinoma with free margins.

Some degree of suspicion for ameloblastic carcinoma should be maintained, in fast-growing recurrent ameloblastoma. Wide local excision remains the treatment of choice with adjuvant radiotherapy being an option in selected cases.