Exploring ameloblastic carcinoma with extensive squamous differentiation: Two case reports and literature insights into clinicopathological significance.

Ameloblastic carcinoma (AC) is a rare malignant odontogenic tumor that combines the architectural features of ameloblastoma with cytological signs of malignancy. Among its histological variations, squamous differentiation is occasionally observed. In this study, we report two mandibular cases of AC, both showing extensive areas of squamous differentiation, and review the literature to explore the potential significance of this feature. The first case involved a 44-year-old male with a multilocular lesion in the mandibular ramus, and the second, a 28-year-old female with bilateral mandibular involvement. Histopathological analysis in both cases revealed basaloid epithelial proliferation with peripheral palisading, stellate reticulum-like areas, and prominent squamous differentiation. Literature analysis identified that 27.0 % of cases with adequate histopathological description exhibited squamous differentiation. These cases predominantly occurred in male patients, with a mean age of 47.6 years, and most frequently affected the posterior mandible. Metastasis was reported in 32 % of cases, and 39 % showed no recurrence during follow-up. Our findings show that squamous differentiation is common, and patients with this feature have clinical characteristics similar to those described in the broader AC literature, with no clear differences identified so far.