Multifocal Large Cystic Liver Metastasis of a Sinonasal Tract Ameloblastoma: An Unusual Clinical Presentation
Bibliographic record
Abstract
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 doi: https://doi.org/10.4021/jmc1314w
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".