Ameloblastoma: current etiopathological concepts and management

Abstract

Ameloblastoma is a benign odontogenic tumor of epithelial origin. It is locally aggressive with unlimited growth capacity and has a high potential for malignant transformation as well as metastasis. Ameloblastoma has no established preventive measures although majority of patients are between ages 30 and 60 years. Molecular and genetic factors that promote oncogenic transformation of odontogenic epithelium to ameloblastoma are strongly linked to dysregulation of multiple genes associated with mitogen-activated protein kinase, sonic hedgehog, and WNT/b-catenin signaling pathways. Treatment of ameloblastoma is focused on surgical resection with a wide margin of normal tissue because of its high propensity for locoregional invasion; but this is often associated with significant patient morbidity. The relatively high recurrence rate of ameloblastoma is influenced by the type of molecular etiological factors, the management approach, and how early the patient presents for treatment. It is expected that further elucidation of molecular factors that orchestrate pathogenesis and recurrence of ameloblastoma will lead to new diagnostic markers and targeted drug therapies for ameloblastoma. Oral Diseases (2018) 24, 307-316

Ultra‐frequent HRAS p.Q61R somatic mutation in canine acanthomatous ameloblastoma reveals pathogenic similarities with human ameloblastoma

“…Ameloblastoma is an odontogenic tumour that is rare in humans but is relatively common in dogs, particularly in golden retrievers, cocker spaniels, Akitas, Shetland sheepdogs and mixed breed dogs . As in humans, ameloblastomas in dogs are more common in the mandible than in the maxilla, and are typically locally aggressive (Figure ) . The standard of care for ameloblastomas has traditionally been wide surgical excision of the affected area of the mandible or maxilla .…”

“…humans, ameloblastomas in dogs are more common in the mandible than in the maxilla, and are typically locally aggressive ( Figure 1). 3,5,6 The standard of care for ameloblastomas has traditionally been wide surgical excision of the affected area of the mandible or maxilla. 7,8 However, surgery is highly invasive and may result in significant disfigurement and dysfunction.…”

Ameloblastoma—Clinical, radiological, and therapeutic findings

“…However, there are geographical differences: Higher incidences are found in Africa, China and India in comparison with the Western World (McClary et al., ). Generally, ameloblastomas are found at an age of 30‐60 years with an average of 36 years and a peak around the fifth decade (Effiom, Ogundana, Akinshipo, & Akintoye, ; Gundlach, ; McClary et al., ). The male to female ratio is 1.2:1.…”

“…Very little is known about molecular risk factors for ameloblastoma. Multiple genetic mutations can increase the risk of developing cancer (Effiom et al., ). Under normal circumstances, cells have the ability to correct the mutations or to undergo apoptosis, unless these mutations affect genes, which code for proteins with repair function.…”

“…Generally, ameloblastomas are found at an age of 30-60 years with an average of 36 years and a peak around the fifth decade (Effiom, Ogundana, Akinshipo, & Akintoye, 2017;Gundlach, 2000;McClary et al, 2016). The male to female ratio is 1.2:1.…”