Conservative Management for Acanthomatous Ameloblastoma of Anterior Maxilla: A Rare Case Report

Abstract

First described by Broca in 1886, Ameloblastoma is one of the most frequently encountered epithelial odontogenic benign tumor. The literature reports Mandible as the utmost favourable area of this tumor with approximately 80% of the cases involving this area. Histologically, an ameloblastoma can have six variations i.e, follicular, plexiform, basal, granular, desmoplastic and/or acanthomatous form. According to the 2005 World Health Organization (WHO) classification the incidence of acanthomatous ameloblastoma is 7.06%. The acanthomatous type of ameloblastoma is deemed to be a rare and uncommon variation that mostly involves the mandible in 81% of the cases and maxilla in only 19% of the cases. In the maxilla, it is most commonly seen in the molar area, antral area and nasal floor with reported rate of occurrence being 47%, 33% and 9% respectively. The incidence in the canine are is only 9%. On the basis of previous studies, acanthomatous ameloblastoma is usually found in the geriatric population than in younger ones and is considered as an aggressive variant of ameloblastoma. Authors hereby present a case of acanthomatous ameloblastoma occurring in the anterior maxilla in a 36-year-old male patient presenting with painless swelling involving the left side of the anterior upper jaw managed with a conservative type of treatment. This type of presentation of the already rare acanthomatous ameloblastoma is extremely sporadic. Also, the occurrence of such a tumour in maxilla can significantly affect the progression and prognosis of such tumours because of the anatomical and histopathological differences in the maxilla and mandible and their densities, thereby further influencing the management and follow-up.