Odontogenic sarcoma and carcinosarcoma

L J Slater
Seminars in Diagnostic Pathology 1999, 16 (4): 325-32
Odontogenic sarcoma is a gnathic malignant connective tissue tumor containing epithelium similar to that seen in an ameloblastoma or ameloblastic fibroma. It is a mixed odontogenic tumor in which the epithelial component is benign and the proliferative mesenchymal component is malignant. With each recurrence, the ameloblastic fibrosarcoma demonstrates increasing evidence of stromal cellularity and mitotic activity but diminishing evidence of odontogenic epithelium. If an ameloblastic fibrosarcoma exhibits dysplastic dentin, it can be called an ameloblastic fibrodentinosarcoma, and if it additionally shows focal deposits of dysplastic enamel proteins, it can be designated an ameloblastic fibro-odontosarcoma. A jaw tumor displaying both a carcinomatous and a malignant spindle cell component can be termed an odontogenic carcinosarcoma if it reveals an ameloblastic fibroma-like pattern. If it lacks this pattern, the appellations "spindle-cell ameloblastic carcinoma" or "biphasic ameloblastic sarcomatoid carcinoma" might be preferable. This is a US government work. There are no restrictions on its use.

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