Bilocular unicystic ameloblastoma of the mandible in a 9 yr old child – A diagnostic and management dilemma

Abstract

Unicystic ameloblastoma is a less encountered variant of the ameloblastoma that usually presented as unicystic lesions of jaw occurring in 3rd and 4th decades of life. It shows a typical ameloblastomatous epithelium lining the cyst cavity, with or without variable tumor proliferations. The case presented here is of a 9 yr old boy who was referred to our center for the management of a large diffuse swelling on the right side of the face. Clinical and radiologic evaluation showed two interconnected cystic lesions in the right body and the symphyseal regions of the mandible associated with impacted canines bilaterally. The initial histopathology of both cystic spaces showed the lesion to be dentigerous cysts and the results were reconfirmed in two other centers. A complete surgical enucleation of this bilocular cyst was done sparing the impacted teeth. The histopathologic examination of the post-operative specimen showed features of Unicystic Ameloblastoma. The patient was followed up on a regular basis for more than 3 years. There is no signs of recurrence and his latest radiographic examinations shows good bone formation. The impacted teeth are erupting into position. This case reports the difficulty in clinical diagnosis and the peculiar bilocular presentation of unicystic ameloblastoma which was conservatively managed by surgical enucleation of the complete lesion, sparing the dentition.

Bilateral ramus mandibulectomy with plate reconstruction in ameloblastic carcinoma patient

“…This therapy was performed on the intraoperative bone margin through tissue fixation, drilling, or cauterizing bone tissue. 8 There was also mandibular reconstruction with a plate and screw in this case. A fibula flap is considered the gold standard of choice owing to its length, bone stock, reliable pedicle, tolerance of dental implants, and low donor-site morbidity.…”

“…The CT scan of a multilocular type of ameloblastoma showed a classic soap bubble appearance. 8 The patient was diagnosed with mandibular ameloblastoma.…”

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

“…Robinson and Martinez in 1977 defined UA as a cystic cavity lined by ameloblastic epithelium [6,7]. UA accounts for about 6% of ameloblastomas and occurs in younger age group with about 50% of the patients presenting in the second decade of life [3,7,8]. Clinical diagnosis of UA is challenging and it is frequently misdiagnosed since they show clinical and radiographic features similar to odontogenic cysts, most commonly a dentigerous cyst.…”

“…Clinical diagnosis of UA is challenging and it is frequently misdiagnosed since they show clinical and radiographic features similar to odontogenic cysts, most commonly a dentigerous cyst. Hence, histopathologic confirmation is mandatory to arrive at a final diagnosis [6,7]. Ackerman in 1988 classified UA on the basis of histopathologic features into three groups [7]:…”

“…Hence, histopathologic confirmation is mandatory to arrive at a final diagnosis [6,7]. Ackerman in 1988 classified UA on the basis of histopathologic features into three groups [7]:…”