A Review of Literature on Ameloblastoma in Children and Adolescents and a Rare Case Report of Ameloblastoma in a 3-Year-Old Child

Abstract

A rare case report of a plexiform unicystic ameloblastoma in a 3-year-old girl stimulated us to conduct a review of literature to understand the correlation of this tumor with various factors such as that of age, sex, histopathological correlation, and its incidence rates pertaining to children and adolescent population. This is a case report of ameloblastoma in a 3-year-old patient, along with a literature review of ameloblastoma in relation to age. A computerized literature search using Medline was conducted for published articles on treatment of ameloblastoma. MeSH phrases used in search were ameloblastoma AND age; ameloblastoma AND children. The search was restricted to published articles from 1970 to 2010, as the histological features were not clearly defined until 1st edition of WHO histological classification of odontogenic tumors of 1971, search parameter was also set to select literatures under English language only. An additional systematic hand search was also conducted simultaneously to identify other published articles, considering similar parameters as used for Medline search. Most of search result yielded literatures in which primary importance were given to treatment patterns and prognosis of intervention, there were not much specific article or meta analysis which reviewed on the affected age range of ameloblastoma exclusively. We reviewed the identified literatures with patients' age, case numbers, incidence, sex, location, and histopathology. The statistical data collected were exported to SPSS 16.0 for windows software which performed a descriptive analysis giving an average mean age of 14.1 years (range from 4 to 20); with maximum mean age being 16.0 and minimum mean age being 10.8 with standard deviation of 1.60. Majority of lesions 91.86% (327 of 356) were found between the age group of 11 and 20 years, only 8.14% (29 of 356) were below the age of 10 years. This rare case report highlights occurrence of plexiform unicystic ameloblastoma in maxilla of a 3-year-old girl, which is very much incongruent with the various review of literature on ameloblastoma in children and adolescents. We have emphasized the significance of patient's age and histopathological pattern of the tumor as it has its influence on the treatment plan. However, there is much of research needed with focus in respect to age, histological pattern, and treatment outcomes.

Recurrence factors in pediatric ameloblastoma: Clinical features and a new classification system

“…5 Similar to previous reports, 89.42% (n = 93) of the tumors in the present study occurred in the mandible. 5 Similar to previous reports, 89.42% (n = 93) of the tumors in the present study occurred in the mandible.…”

“…1,2 The most common pathological diagnosis is ameloblastoma, which accounts for nearly 25% of tumors of the jaw in children. 5 Although ameloblastomas are primarily intraosseous tumors, they can occasionally occur in soft tissues. 5 Although ameloblastomas are primarily intraosseous tumors, they can occasionally occur in soft tissues.…”

“…5 Although ameloblastomas are primarily intraosseous tumors, they can occasionally occur in soft tissues. 5 Ameloblastomas have been observed to extend 2 to 8 mm (average 4.5 mm) beyond the clinical margin on microscopic examination. 5 Ameloblastomas have been observed to extend 2 to 8 mm (average 4.5 mm) beyond the clinical margin on microscopic examination.…”

“…3 The incidence of ameloblastoma worldwide has been estimated to be 0.5 cases per million people each year, 4 and the incidence of ameloblastoma in people below the age of 18 years is 16.9%. 5 Although ameloblastomas are primarily intraosseous tumors, they can occasionally occur in soft tissues. 6 Ameloblastomas generally occur five times more frequently in the mandible than in the maxilla, but in pediatric cases, the mandible (96.67%) is 29 times more likely to be affected than the maxilla (3.3%).…”

“…6 Ameloblastomas generally occur five times more frequently in the mandible than in the maxilla, but in pediatric cases, the mandible (96.67%) is 29 times more likely to be affected than the maxilla (3.3%). 5 Ameloblastomas have been observed to extend 2 to 8 mm (average 4.5 mm) beyond the clinical margin on microscopic examination. 7 Therefore, surgical excision with a minimum of 1 cm margins in adjacent normal tissue is the treatment of choice for most subtypes of ameloblastomas.…”