Extensive ameloblastoma in young patient: 5-year follow-up with no recurrence using conservative treatment

Joyce Natiele Da Silva,João Adolfo Costa Hanemann,André Caroli Rocha,Marina Lara De Carli,Cassiano Nogueira Dos Santos,Alessandro Antônio Costa Pereira

doi:10.1590/1981-8637201800020000133357

Joyce Natiele Da Silva, João Adolfo Costa Hanemann + Show 4 more

Open Access

https://doi.org/10.1590/1981-8637201800020000133357

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Abstract

ABSTRACT Ameloblastoma is a benign, odontogenic tumor that, due to its low rate of incidence, slow growth and local invasiveness, can be treated with a variety of surgical approaches, ranging from conservative to radical procedures. The conventional variant of ameloblastoma, though, is more aggressive and common, presenting a higher rate of recurrence than the unicystic and extraosseous/peripheral types; usually, the treatment of choice for this variant employs more invasive procedures. This report is of a 13-year-old male patient who presented with a swelling on the posterior mandibular region, on the left side of his face. Intraoral examination revealed lingual displacement of teeth 36 and 37. The clinical, radiographic and histopathological analyses confirmed the diagnosis of ameloblastoma (plexiform histological type). The patient was treated with curettage and peripheral osteotomy and a 5-year follow-up examination showed the area to have healed completely, with no evidence of recurrence. Consequently, although the clinical management of ameloblastoma is often based on invasive surgical approaches, large tumors treated with conservative surgery are less aesthetically and functionally impaired, and may demonstrate good prognosis with no recurrence in the 5-year follow-up period, as in the case reported here.

Highlights

Ameloblastoma is a slow-growing, locally invasive, benign epithelial odontogenic tumor (EOT)
Ameloblastomas occur at any age, the literature [2,3,4] reporting that the majority of cases are diagnosed in individuals aged between 30 and 60, and approximately 80% of cases occur in the mandible [1,4,5,6], predominantly in the region of the molars and ramus7,8 and have a high rate of recurrence [5,6,7,8]
According to the latest edition of the book on Head and Neck Tumors published by the World Health Organization (WHO) [9] at the beginning of 2017, ameloblastoma can be classified as: ameloblastoma, unicystic ameloblastoma or extraosseous/peripheral ameloblastoma, with the terminology solid or multicystic, used since the last WHO classification in 2005, being discarded as it has no biological meaning, while the term desmoplastic will no longer be used as a clinicalpathological entity but rather as a histological subtype

Summary

INTRODUCTION

Ameloblastoma is a slow-growing, locally invasive, benign epithelial odontogenic tumor (EOT). Extensive ameloblastoma in young patient: 5-year follow-up with no recurrence using conservative treatment. The proposal of the present study is to present and discuss conservative treatment of an extensive ameloblastoma in a teenage patient, emphasizing the relevant circumstances of the surgical approach employed relating to curettage and peripheral osteotomy. We noted a slight limitation in oral aperture, a diffuse tumefaction in the region of the left-side mandibular body and angle, causing asymmetry of the face (Figure 1). The radiographic examination revealed an extensive multilocular radiolucent lesion in the left-side posterior mandibular region, with root resorption of teeth and and displacement of the germ of tooth to the base of the mandible, close to the angle. 13-year-old male patient with diffuse tumefaction in the left-side region of the mandibular body and angle, causing asymmetry of the face, nonpainful and firm on palpation. Place and year of the study: UNIFAL, Alfenas, in 2011

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DISCUSSION

CONCLUSION