Multifocal Large Cystic Liver Metastasis of a Sinonasal Tract Ameloblastoma: An Unusual Clinical Presentation

Xiuli Liu, Hao Xie, Huamin Wang, James McMahon, Deepa T. Patil, Lisa M. Yerian


Ameloblastoma is a slowly growing, locally invasive tumor of odontogenic epithelial origin. On rare occasion, a well-differentiated ameloblastoma may metastasize. Recently, we encountered a unique case of metastatic ameloblastoma in the liver in a 48-year-old woman. Preoperative radiographic study revealed multiple cystic lesions in the liver, 6 of which were confirmed intraoperatively. Macroscopic examination of the resected tumors revealed well-circumscribed, encapsulated cystic lesions. Sections from the tumors demonstrated solid interlocking islands with peripheral palisading of basaloid cells and squamous differentiation of centrally located cells. The cytology of these tumors was bland and the mitotic activity was low. Immunohistochemistry showed immunoreactivity for CK5/6 and p63, immunoreactivity for CD10 in the peripherally palisading cells and immunoreactivity for CK19 in the centrally located cells. The resected liver cystic tumors were originally diagnosed as low-grade cystic ameloblastoma-like tumor in the liver and suggested a possibility of metastasis. The patient was doing well clinically after the resection of her liver lesions. However, CT scan of the head and neck region at another hospital one year later showed an enhancing, expansile, well circumscribed mass in the right nasal cavity. Biopsy and resection of the nasal mass revealed an ameloblastoma invading the maxillary bone. The patient is doing well 2 months after her nasal surgery. To our knowledge, this is the first case of ameloblastoma manifested as liver metastases prior to the identification of a sinonasal primary.

J Med Cases. 2013;4(8):544-549


Liver; Ameloblastoma; CD10; P63; Squamous cell carcinoma; Sinonasal tract

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.