Abstract
Unicystic ameloblastoma (UA) is a benign epithelial odontogenic tumor of the jaws that commonly occurs in 2nd and 3rd decade of life. In fact, this entity is rare in children under 12 years of age. It is characterised as a distinct variant of ameloblastoma, exhibiting a less aggressive behaviour and a lower rate of recurrence than solid conventional ameloblastoma. There are very few reported cases of UA occurring in children below five years of age. The purpose of this case report is to describe a case of UA involving the crown of an unerupted maxillary second premolar in a 3 year old girl. The pathogenesis, clinical appearance, radiographic presentation, histological findings and management of the tumour have also been discussed.
Highlights
Unicystic ameloblastoma (UA) is usually seen in younger patients as compared to solid ameloblastomas, with most tumours diagnosed during the second decade [8]
A thorough search of available literature revealed that the present case of UA in a 3 year old girl is probably the youngest reported patient of UA in the English literature
Leider et al proposed three pathogenic mechanisms of evolution of UA [11]: 1) Reduced enamel epithelium associated with a developing tooth undergoes ameloblastic transformation with subsequent cystic development
Summary
Ameloblastoma is one of the most common benign odontogenic tumours, accounting for approximately 1% of all tumours and cysts of the jaws and 10% of all odontogenic tumors [1,2]. Unicystic ameloblastoma (UA), refers to those cystic lesions that show clinical and radiological features of an odontogenic cyst but in histological examination show ameloblastomatous epithelium lining the cyst cavity with or without luminal or mural proliferation [3]. Axial CT sections showed an expansile, well corticated cystic lesion involving partially formed maxillary left premolars (Fig. 1). Increased vascularity was noted in supportive fibrocollagenous stroma (Fig. 3) Based on these features, a diagnosis of Unicystic Ameloblastoma (Type 1.2) was made. The patient is under follow up for 15 months and no recurrence has been noted till date With these findings, a provisional diagnosis of dentigerous cyst was made and the lesion was enucleated under local anaesthesia. The gross specimen received was a cystic sac measuring 3.5x3x2.5 cms along with partially formed canine and e55
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