Ameloblastoma: Management and Outcome

Abstract

IntroductionAmeloblastoma is a locally destructive tumor with a propensity for recurrence if not entirely excised. Management of ameloblastoma poses a challenge for all involved in the field of head and neck surgery because successful treatment requires not only adequate resection but also a functional and aesthetically acceptable reconstruction of the residual defect.MethodsPatients who had histologically proven ameloblastoma between 1991 and 2009 were identified from the database of Aga Khan University Hospital. A review of all medical records, radiological images, operative reports and pathology reports was undertaken.ResultsA total of 15 patients with histologically confirmed ameloblastoma were identified. Out of 15 patients nine were males and six were females with age range from 20 to 60 years (mean age 43 years). The most common symptom found in our patient group was painless facial swelling. In 13 patients the origin of tumor was mandible and in the remaining two the tumor originated from maxilla. Eleven out of 15 patients underwent segmental mandibulectomy, two had maxillectomy and two had enucleation. All patients who underwent segmental mandibulectomy required reconstruction. Reconstruction was done with microsurgical free tissue transfer in eight patients, non-vascularized iliac crest bone graft was used in one patient and two had plating only. All free flaps survived with no evidence of flap loss. The mean follow-up was eight years. There was no evidence of graft failure which was used in one patient. Complication was seen in only one of our patients in the form of plate exposure. Recurrence was seen in two of our cases who primarily underwent enucleation. All patients had satisfactory speech, cosmesis and mastication.ConclusionThe management of ameloblastoma still poses a big challenge in spite of being the most common odontogenic tumor. In our study we have found that segmental mandibulectomy with disease-free margin of around 1 cm and immediate reconstruction with free tissue transfer have shown good results.

A rare case of maxillary ameloblastoma with lung metastasis: a case report

“…Metastatic ameloblastoma refers to a lesion that metastasizes to a distant organ but the histology of both primary and metastatic tissues is benign [11]. It is an infrequent entity, accounting for approximately 2% of ameloblastoma cases [12].…”

Ameloblastoma: clinical presentation, multidisciplinary management and outcome

“…Ameloblastoma is a rare head and neck tumor with an estimated annual incidence of 0.5 per million population [ 1 , 2 ]. They constitute 1% of tumors and cysts involving the jaws and accounts for approximately 10% of the odontogenic tumors [ 3 ].…”

Mural Variant of Unicystic Ameloblastoma in a Pediatric Patient: A Rare Case Report

“…Ameloblastoma is the most common benign, odontogenic tumor of epithelial origin [1,2]. The WHO defines ameloblastoma as a benign but locally invasive polymorphic neoplasm consisting of proliferating odontogenic epithelium, usually having a follicular or plexiform pattern, lying in a fibrous stroma.…”

“…The WHO defines ameloblastoma as a benign but locally invasive polymorphic neoplasm consisting of proliferating odontogenic epithelium, usually having a follicular or plexiform pattern, lying in a fibrous stroma. It presents as an asymptomatic slow growing lesion which predominantly occurs in the mandible [2]. There is no sex predilection with a peak incidence in the third to fourth decade of life [1,3].…”