CLINICAL AND SURGICAL CONDUCT IN AMELOBLASTOMA OF LARGE DIMENSIONS

Abstract

We describe a case of a 32-year-old male patient with extensive extra and intraoral enlargement of volume. Seven years earlier, he had undergone incisional biopsy and had histopathological diagnosis of ameloblastoma. However, the patient refused the proposed treatment. Panoramic radiography revealed multilocular radiolucency extending from right ascending ramus to tooth 36. Given the previous history, marginal resection and facial reconstruction were performed. Microscopic analysis revealed proliferation of islands and cords of odontogenic epithelium in a fibrovascular stroma. Peripheral cells of these arrangements were columnar, with hyperchromatic nuclei, exhibiting organization in palisade and reverse polarization, resembling ameloblasts. Central cells were loosely arranged, resembling stellate reticulum of the enamel organ. After the surgical intervention, the patient was referred for oral rehabilitation and remains in follow-up. Given the clinical behavior of ameloblastoma, we recommend the patient to be aware of the aggressiveness of the lesion to reduce the morbidity. We describe a case of a 32-year-old male patient with extensive extra and intraoral enlargement of volume. Seven years earlier, he had undergone incisional biopsy and had histopathological diagnosis of ameloblastoma. However, the patient refused the proposed treatment. Panoramic radiography revealed multilocular radiolucency extending from right ascending ramus to tooth 36. Given the previous history, marginal resection and facial reconstruction were performed. Microscopic analysis revealed proliferation of islands and cords of odontogenic epithelium in a fibrovascular stroma. Peripheral cells of these arrangements were columnar, with hyperchromatic nuclei, exhibiting organization in palisade and reverse polarization, resembling ameloblasts. Central cells were loosely arranged, resembling stellate reticulum of the enamel organ. After the surgical intervention, the patient was referred for oral rehabilitation and remains in follow-up. Given the clinical behavior of ameloblastoma, we recommend the patient to be aware of the aggressiveness of the lesion to reduce the morbidity.