LAUSR

BACKGROUNDS Ameloblastic carcinoma, a rare malignant odontogenic tumor, is difficult to diagnosis and treat. Here, we retrospectively analyzed its epidemiology, prognosis, and atypical ameloblastoma, a lesion insufficient to diagnose as ameloblastic carcinoma, to provide insights for understanding. METHODS This study included 23 cases of ameloblastic carcinoma and 31 of atypical ameloblastoma from 2004 to 2024. Epidemiology, clinical symptoms, radiographic features, treatment, and prognosis were analyzed. RESULTS Regarding ameloblastic carcinoma, 15 males and 8 females ranging from 21 to 85 years old were included, with an average of 51.57. Eleven cases (47.8%) occurred in the maxilla. The main symptom was swelling, and the radiographic features included honeycomb-like features. The prognosis was revealed during the 1- to 19-year follow-up; 11 patients did not experience recurrence, 4 experienced recurrence, 7 died, and 1 was missing. The prognosis analysis revealed site, type and therapy without flap repair might be associated with recurrence, suggesting prompt extended resection might be the preferred treatment. Among patients with atypical ameloblastoma, 2 patients subsequently developed ameloblastic carcinoma, and 5 experienced recurrence. CONCLUSION Ameloblastic carcinoma, a rare malignant tumor with high recurrence and mortality rates, and atypical ameloblastoma with a potential for malignancy should receive prompt treatment and rigorous follow-up.