Benign Epithelial Tumors Research Articles

Tumour Incidence in Dogs in Germany: a Retrospective Analysis of 109,616 Histopathological Diagnoses (2014–2019)

Characterization of a tumour entity is based on the precise histopathological diagnosis taking into account the signalment of the diseased animal. The present study is a comprehensive, up-to-date statistical investigation on the type, frequency and breed distribution of neoplasia in dogs in Germany. The histopathological datasets of 109,616 German canine tissue samples (2014-2019) were processed and statistically examined in retrospect. Non-neoplastic diseases were found in 38,650 samples (35.3%) and 70,966 neoplasms (64.7%) were diagnosed. The most common neoplasms were mammary tumours (21.9%), benign epithelial skin tumours (15.4%), mast cell tumour (9.7%), histiocytoma (7.0%), soft tissue sarcoma (5.8%), lipoma (5.8%), melanocytic tumours (5.2%) and odontogenic tumours (4.7%). In general, Beagles, Magyar Vizslas, Boxers, Schnauzers, Spaniels, French Bulldogs and Golden Retrievers had an increased risk of neoplasia (odds ratio 1.17-1.46; all: P ≤0.001) compared with crossbreed dogs. In particular, Boxers, Golden Retrievers, Rottweilers and Schnauzers were often affected by malignant neoplasms, whereas some breeds (eg, West Highland White Terrier, Magyar Vizsla, Chihuahua, Dachshund and Yorkshire Terrier) were frequently affected by numerous benign tumour types. Despite the known risk of haemangiosarcoma in German Shepherd Dogs, other malignant tumours were rare in this breed. Depending on the type of tumour, some purebred dog breeds can have an increased, reduced or identical risk for certain neoplasms compared with crossbreeds. Discussion of breed predispositions to tumour diseases must therefore be conducted critically and with a view to clinical relevance.

CD163 Immunohistochemical "Circle Sign" Staining Pattern Differentiates Sinonasal Papillomas From Morphologically Similar Non-neoplastic Lesions.

Sinonasal papillomas are a diverse group of benign epithelial neoplasms of the sinonasal tract. Inverted papilloma, in particular, must be distinguished from other lesions with no malignant potential. The aim of this study was to distinguish sinonasal papillomas from morphologically similar lesions using CD163 immunostaining. Cases from a 19-year period were identified. These included 49 inverted, 10 exophytic, and 12 oncocytic papillomas, 21 chronic sinusitides with squamous metaplasia, 27 inflammatory polyps, 5 verrucae vulgares, 5 respiratory epithelial adenomatoid hamartomas, and 6 DEK::AFF2 carcinomas of the sinonasal tract. A subset of biopsy cases (8 inverted papillomas, 5 inflammatory polyps) was separately analyzed. CD163 immunohistochemistry (IHC) was performed. A unique "circle" staining pattern was identified in the surface epithelium. After locating a hotspot, circles were quantified in 10 consecutive high-power fields. Circles were present in 66/71 (93%) cases of sinonasal papilloma, with a mean of 35 circles/10HPF (range: 0 to 160/10HPF) and a median of 19 circles/10HPF. Circles were present in 20/58 (34%) non-neoplastic cases, with a mean of 2 circles/10HPF (range: 0 to 27/10HPF) and a median of 0. Considering all resection and biopsy cases, performance for distinguishing papillomas from non-neoplastic lesions was best at a cutoff of 10 circles/10HPF (2-tailed P <0.0001) with sensitivity, specificity, positive predictive value, and negative predictive value of 66.2%, 93.1%, 92.1%, and 69.2%, respectively. The results were similar in the biopsy subset. One other neoplastic entity, the DEK::AFF2 carcinomas, also showed prominent CD163 circle staining. In summary, sinonasal papillomas demonstrate extensive CD163 "circle" staining in the epithelium compared with the non-neoplastic lesions studied. As such, the "circle sign" on CD163 IHC may be helpful in distinguishing between diagnoses, particularly on small biopsies or equivocal specimens.

AMELOBLASTOMA RECURRENCE ASSOCIATED WITH AMELOBLASTIC FIBROMA: A RARE CASE REPORT

Ameloblastoma is an aggressive odontogenic tumor with a relatively high recurrence rate. A 60-year-old male patient presented, in a follow-up computed tomography, an osteolytic isodense lesion obliterating the left maxillary sinus and involving the orbit floor, zygomatic bone, and infratemporal fossa. The lesion was asymptomatic, and no facial asymmetry was observed. His past medical history revealed ameloblastoma in the left ramus of the mandible, coronoid process, which was surgically treated 10 years prior. The clinical diagnosis was recurrent ameloblastoma. Excisional biopsy revealed areas of benign epithelial odontogenic neoplasm characterized by a cystic cavity lined by ameloblastomatous epithelium and stroma of fibrous connective tissue, and areas of benign mixed odontogenic tumor composed of ameloblastic cells in a myxoid and cell-rich mesenchyma. The final diagnosis was ameloblastoma associated with ameloblastic fibroma. The patient underwent rehabilitation and has been followed up, showing no signs of local complications.

MULTIDISCIPLINARY TREATMENT AND FOLLOW-UP OF AMELOBLASTOMA: CASE REPORT

Ameloblastoma is a benign epithelial odontogenic neoplasm with aggressive biological behavior and a tendency for local recurrence. A 21-year-old male patient was referred for treatment for an asymptomatic small intraoral swelling on the left posterior mandible. Clinical examination showed the absence of left molars and no extraoral asymmetry. Panoramic radiography revealed a unicystic radiolucent lesion. Previously, the patient was submitted to an incisional biopsy with a histopathologic diagnosis of ameloblastoma. The treatment was excision of the lesion followed by peripheral osteotomy and application of Carnoy's solution, and the surgical specimen was sent for histopathologic analysis. Microscopic examination confirmed the diagnosis of ameloblastoma presenting proliferation of islands and cords of odontogenic epithelium. Peripheral cells were arranged in a palisading pattern with reverse polarity and central cells were loosely arranged. The stroma consisted of fibrous connective tissue. The patient has been under follow-up for about 2 years without recurrence.

SURGICAL MANAGEMENT OF UNICYSTIC AMELOBLASTOMA: CONSERVATIVE OR RADICAL APPROACH: A SYSTEMATIC REVIEW

<h3>Objectives</h3> Unicystic ameloblastoma is a benign epithelial odontogenic neoplasm that represents about 5% to 15% of all intraosseous ameloblastomas, and its biological behavior is related to its histopathologic subtypes, with the mural variant being the most aggressive. The aim was to evaluate the effectiveness of conservative and radical surgical approaches in the treatment of unicystic ameloblastomas. <h3>Study Design</h3> A systematic literature review was performed using the Science Direct, Embase, Cochrane Collaboration Library, and PubMed/MEDLINE databases. Studies related to conservative and radical surgical therapies for the treatment of unicystic ameloblastomas were selected. <h3>Results</h3> Seven hundred ninety-one studies were found. After screening the titles and abstracts, 25 studies were considered eligible and read by the evaluators. After the analysis, 5 articles met all inclusion criteria and were included in this review. <h3>Conclusions</h3> Studies have shown that a conservative surgical approach for the treatment of unicystic ameloblastoma is recommended only for the luminal and intraluminal variants and is not recommended for the mural subtype. However, to carry out a radical treatment, one must consider the age and health of the patient. Postsurgical clinical and radiographic monitoring is of fundamental importance for early detection of recurrence.

PERIPHERAL DENTINOGENIC GHOST CELL TUMOR: CASE REPORT

Peripheral dentinogenic ghost cell tumor (DGCT) is a rare benign mixed epithelial and mesenchymal odontogenic neoplasm, with approximately 52 cases reported in the literature. A 48-year-old woman was referred for evaluation of a painless, slow-growing swelling in the mandible caused by a removable denture that evolved over 1 year. Her medical history was unremarkable. Intraoral examination showed a pinkish, firm nodule, with erythematous areas, in the left mandibular alveolar ridge. Panoramic radiographic examination revealed no signs of bone involvement. Under the diagnostic hypothesis of inflammatory fibrous hyperplasia, an incisional biopsy was performed. Histopathologic analysis disclosed sheets and islands of odontogenic epithelium, with areas closely resembling ameloblastoma. Ghost cells, dentinoid material, and inflammatory foreign body reaction with multinucleated giant cells were also observed. The final diagnosis was peripheral DGCT. Treatment consisted of surgical excision, and no signs of recurrence were detected after 2 months of clinical follow-up.

CLINICAL, RADIOGRAPHIC AND MORPHOLOGICAL FEATURES OF AMELOBLASTOMA: A CASE REPORT

Ameloblastoma is a benign epithelial odontogenic neoplasm with an aggressive biological behavior with a tendency of local recurrence. A 21-year-old male patient was referred for treatment for an asymptomatic small intraoral swelling on the left posterior mandible. Clinical examination showed the absence of left molars and no extraoral asymmetry. Panoramic radiography revealed an unicystic radiolucent lesion. Previously, the patient was submitted to an incisional biopsy with a histopathologic diagnosis of ameloblastoma. The treatment was excision of the lesion followed by peripheral osteotomy and application of Carnoy's solution, and the surgical specimen was sent for histopathologic analysis. Microscopic examination confirmed the diagnosis of ameloblastoma presenting proliferation of islands and cords of odontogenic epithelium. Peripheral cells were arranged in a palisading pattern with reverse polarity and central cells were loosely arranged. The stroma consisted of fibrous connective tissue. The patient has been under a follow-up for about 2 years without recurrence.

CONSERVATIVE TREATMENT OF AMELOBLASTOMA THROUGH DECOMPRESSION, WITH FOLLOW-UP FOR 5 YEARS

Ameloblastoma is a locally aggressive benign epithelial odontogenic tumor. The treatment can be radical or conservative, but the chosen technique is still controversial. We report the case of a 16-year-old patient, presenting a volumetric increase in the posterior region of the mandible, symptomatic and hardened on palpation. In imaging studies, a radiolucent, unilocular lesion was found, involving the region of the lower right first molar to the coronoid process, associated with the included third molar. An aspiration puncture was performed, showing citrus yellow liquid, followed by incisional biopsy, with extraction of teeth 47 and 48 and installation of a decompression device. The diagnosis was conventional ameloblastoma. The lesion completely regressed through decompression for a period of 1 year and the patient has been followed up for 5 years without recurrence. When conservative treatment is chosen, strict periodic clinical radiographic monitoring is essential.

T2-weighted MRI-based radiomics for discriminating between benign and borderline epithelial ovarian tumors: a multicenter study

BackgroundPreoperative differentiation between benign and borderline epithelial ovarian tumors (EOTs) is challenging and can significantly impact clinical decision making. The purpose was to investigate whether radiomics based on T2-weighted MRI can discriminate between benign and borderline EOTs preoperatively.MethodsA total of 417 patients (309, 78, and 30 samples in the training and internal and external validation sets) with pathologically proven benign and borderline EOTs were included in this multicenter study. In total, 1130 radiomics features were extracted from manually delineated tumor volumes of interest on images. The following three different models were constructed and evaluated: radiomics features only (radiomics model); clinical and radiological characteristics only (clinic-radiological model); and a combination of them all (combined model). The diagnostic performances of models were assessed using receiver operating characteristic (ROC) analysis, and area under the ROC curves (AUCs) were compared using the DeLong test.ResultsThe best machine learning algorithm to distinguish borderline from benign EOTs was the logistic regression. The combined model achieved the best performance in discriminating between benign and borderline EOTs, with an AUC of 0.86 ± 0.07. The radiomics model showed a moderate AUC of 0.82 ± 0.07, outperforming the clinic-radiological model (AUC of 0.79 ± 0.06). In the external validation set, the combined model performed significantly better than the clinic-radiological model (AUCs of 0.86 vs. 0.63, p = 0.021 [DeLong test]).ConclusionsRadiomics, based on T2-weighted MRI, can provide critical diagnostic information for discriminating between benign and borderline EOTs, thus having the potential to aid personalized treatment options.

Analysis of lesion location and disease characteristics of pharyngeal and laryngeal papilloma in adult.

Papilloma is a common benign epithelial tumor of the respiratory tract in adults. Its histological structure and immune environment vary from site to site. This study investigated the disease characteristics and prognostic differences of papillomas at various primary locations. Clinical data was collected from patients with adult glossal root and hypopharyngeal papilloma admitted to our tertiary referral center between January 2010 and December 2020, and compared with patients with laryngeal papilloma. Differences in age, sex, smoking, alcohol consumption, single or multiple lesions, surgical methods, immunohistochemical indexes, Ki-67 and p16, were analyzed in patients with different primary papilloma sites. A total of 84 cases of glossal root papilloma, 51 cases of hypopharyngeal papilloma, and 51 cases of laryngeal papilloma were included. Differential analysis between groups showed that there were statistically significant differences in age, sex, smoking, single and multiple lesions, and surgical methods in the different primary sites. Ki-67 expression in laryngeal papilloma was higher than that in glossal root and hypopharyngeal papilloma. There was no significant difference in p16 expression in the three groups. In terms of prognosis, laryngeal papilloma is more likely to relapse than glossal root or hypopharyngeal papilloma, and the recurrence time is shorter. As the largest clinical study of papilloma in different primary locations, this study found that the clinical characteristics and postoperative recurrence of papilloma of the glossal root and hypopharynx differ from those of papilloma of the larynx. This finding supports the current clinical experience in treating papillomas in different locations and facilitates the development of clinical treatment plans.

Carcinoma Ex Combined Inverted and Oncocytic Types Sinonasal Papilloma with Multifocal Severe Dysplasia: A Case Report

Sinonasal papillomas, also called Schneiderian papillomas, are uncommon benign epithelial tumors arising from the pseudostratified ciliated sinonasal mucosa. Three subtypes of sinonasal papillomas have been described, namely exophytic papilloma, inverted papilloma, and oncocytic papilloma. These papillomas usually have a favorable prognosis, however, frequent recurrences and local aggressiveness has been observed. These may undergo malignant transformation in rare instances. We report a case of a 70-year-old male with multiple co-morbidities presenting with nasal obstruction and bleeding for 3 months. CT and MRI sinuses demonstrated a polypoid mass within the right nasal cavity extending into the nasopharynx, likely arising from the right maxillary sinus. Histopathology revealed a diagnosis of carcinoma (poorly differentiated, NOS) ex combined inverted and oncocytic types sinonasal papilloma (Schneiderian papilloma) with multifocal severe dysplasia (carcinoma in situ). Importance of correct diagnosis lies in the fact that these tumors show recurrence and malignant transformation, thus, requiring long-term follow-up. Keywords: Schneiderian papilloma; Sinonasal papilloma; Malignant transformation; Radiotherapy; Oncocytic

Squamous Cell Papilloma of the Conjunctiva

A 74-year-old man presented to the ophthalmology department with an 8-month history of a tumor in his left eye. Examination showed a fleshy tumor with a cauliflower-like appearance involving the conjunctiva and cornea (Fig A). An excisional biopsy was performed, and pathological analysis showed squamous cell papilloma of the conjunctiva. Histology slide showed papilloma of the conjunctiva (Fig B). Conjunctival papilloma is an acquired benign epithelial tumor of the conjunctiva, and may manifest as a sessile or pedunculated conjunctival mass.

Endoscopic submucosal tunnel dissection in the treatment of large benign colon neoplasms. Immediate results

Aim: to evaluate the early results of endoscopic submucosal tunnel dissection (ESTD for large benign colon neo-plasms. Patients and methods: a prospective non-randomized comparative study included 100 patients with large benignepithelial colon neoplasms (more than 3 cm in diameter). The main group included 50 patients who underwentendoscopic submucosal tunnel dissection. The control group included 50 patients who underwent traditional endo-scopic submucosal dissection (ESD). Results: Four (4 %) patients (1 in the main and 3 in the control group) were excluded from the study due to theconversion of endoscopic procedure. The incidence en bloc removal of neoplasms and the negative resection margins were significantly higher in the main group than in the control one — 98 % and 87.2 % (p = 0.04) and 89.8 % and 70.2 %, respectively (p = 0.01). Conclusion: ESTD for large benign epithelial colon neoplasms shows better radicalness in comparison with endo-scopic submucosal dissection.

2940-nm erbium:YAG laser versus 980-nm diode laser in the treatment of multiple seborrheic keratoses: A prospective comparative randomized study.

Seborrheic keratoses (SKs) are the most common benign epithelial tumors encountered in clinical practice. Complications associated with traditional treatments of SKs urge the scientists to seek alternative treatment modalities. Objective To compare the efficacy and safety of 2940-nm erbium-doped yttrium aluminum garnet (Er:YAG) laser versus 980-nm diode laser both clinically and dermoscopically for the treatment of seborrheic keratosis. Thirty subjects with multiple SKs were randomized to receive two sessions of either Er:YAG laser (n=15) or diode laser (n=15) and were followed up for 2 weeks after each session, and at 3 and 6 months after the second session. Both lasers exhibited significant clearance of SKs with no significant difference in clinical and dermoscopic improvement between the two systems. However, Er:YAG laser showed shorter total downtime but more serious erythema, while scarring and hyperpigmentation were observed in diode laser group. No recurrence was detected in both groups at 6 months follow-up. Er:YAG and diode lasers both are effective, non-invasive and well-tolerated techniques in treatment of SKs.

Multiple Intraabdominal and Pelvic Cystadenomas From Ovarian Remnant Syndrome

Serous cystadenomas are benign epithelial neoplasms of the ovary, and they typically have an average size of around 10cm. Our patient is a 68-year-old female who originally presented with abdominal page. Our patient's prior surgical history includes a bilateral salpingo-oophorectomy. Computed tomography scans showed five abdominal and pelvic masses of significant size. Our patient elected to undergo exploratory laparotomy and mass excision, and all five masses were able to be removed successfully. Final pathology confirmed the diagnosis of serous cystadenomas consistent with ovarian origin despite our patient undergoing a previous bilateral salpingo-oophorectomy. Our patient presented with a rare syndrome known as ovarian remnant syndrome that is thought to be caused by difficult hysterectomy procedures and prior abdominal surgeries that can unknowingly leave ovarian remnants. Second, the patient was found to have 5 abdominal and pelvic masses, and most of the masses were a very large size.

Adamantinomatous craniopharyngioma of cerebellopontine angle in association with Gardner’s syndrome

Background. Craniopharyngiomas are benign epithelial tumors. According to embryogenetic theory, these neoplasms develop from the remains of the cells of Rathke’s pouch, which connects the cavities of the primary oral tube with the pituitary gland in the embryonic period. The metaplastic theory assumes the occurrence of craniopharyngiomas as a result of metaplasia of epithelial cells in the chiasmal-sellar region.Objective. To present a clinical case of ectopic adamantium-like craniopharyngioma of the right cerebellopontine angle associated with Gardner’s syndrome.Design and methods. The analysis of SCT, MRI, histological, histochemical and other special studies, as well as data from four other similar observations published in the literature, was carried out.Results. We describe a case of a rare case of ectopic adamantium-like craniopharyngioma of the right cerebellopontine angle associated with Gardner’s syndrome (familial adenomatous polyposis, multiple skull osteomas and soft tissue tumors) diagnosed in a 27-year-old patient. It is noted, while inexplicable, the correlation of craniopharyngiomas in patients with Gardner’s syndrome in the region of the cerebellopontine angle.Conclusions. In the case of patients with adamantine-like craniopharyngiomas, the including of collection of a family history and special studies to exclude adenomatous intestinal polyposis and Gardner syndrome in the complex of treatment and diagnostics id highly recommended.

CHANGING TRENDS IN BENIGN HUMAN PAPILLOMA VIRUS (HPV) RELATED EPITHELIAL NEOPLASMS OF THE ORAL CAVITY: 1995-2015

<h3>Introduction</h3> HPV-related benign papillary epithelial neoplasms are common lesions affecting any region of the oral cavity. This study evaluated the trends in frequency, location, and demographics of these lesions over 20 years. <h3>Materials and Methods</h3> Following IRB approval, the archives of UF Oral Pathology Biopsy Service between 19952015 were queried. Squamous papilloma, verruca vulgaris, and viral papilloma/condyloma were included. Extraoral locations, inconclusive diagnoses, or syndrome-related HPV lesions (Heck disease) were excluded. Age, gender, location, clinical presentation, and diagnoses were recorded. Data from one calendar year per 5-year span was assessed including the years 1995, 2000, 2005, 2010, and 2015. <h3>Results</h3> A total of 1458 cases were identified over the total 5 calendar years assessed. Papilloma as a percentage of total biopsies per year was as follows: 1995 (2.6%), 2000 (3.3%), 2005 (3.6%), 2010 (4%) and 2015 (4.5%), representing a 73% (1.9x) percentage increase. Males (56%) were affected more commonly; however, in patients under 19 years, a female predominance was observed. The overall percentage of lesions in females increased by 30.6% over the time frame. Mean age was 54 years (range 1-93 years) and increased by 10 years over time. About 1.1% of patients had multifocal lesions and 0.2% had a recurrence. In descending order of frequency, tongue, soft palate, and mandibular gingiva were most involved. Maxillary gingiva and lower lip were the most common locations in patients under 19. Location varied over time with the biggest increase noted on the gingiva. Squamous papilloma was the most common histologic variant (93.6%). <h3>Conclusion</h3> The incidence of benign HPV-related oral lesions increased substantially over the 2 decades studied. Other trends noted included increase in the following: average age of patients, female involvement, and gingival location. Our results likely indicate an overall increase in the prevalence of benign oral HPV lesions in our population.

Increased Neutrophil Infiltration and Epithelial Cell Proliferation in Sinonasal Inverted Papilloma Compared to Contralateral Nasal Polyps.

Sinonasal inverted papilloma (IP) is a rare and benign epithelial tumor in the sinonasal tract. Recent study suggested the potential role of chronic inflammation in the pathogenesis of IP. This study aims to compare the inflammatory pattern, the capacity of epithelial cell proliferation and EGFR mutation status of unilateral IP with contralateral polyp tissue. Sixteen patients with unilateral IP and contralateral nasal polyps (NP) were identified through a retrospective chart review. The neutrophil and eosinophil infiltration in IP and NP were assessed by immunostaining for neutrophil elastase and major basic protein (MBP). Immunohistochemistry was also used to assess the expression of FoxM1, Ki67 and cyclin D1 in IP tissue and contralateral NP. Sanger sequencing was used to evaluate the EGFR mutations. The neutrophil count in IP was significantly higher than contralateral NP and 68.8% patients presented with neutrophilic inflammation, whereas only 37.5% contralateral NP tissue showed neutrophilic inflammation. The percentage of positive FoxM1-staining cells was significantly increased in IP, and positively correlated with the percentage of cells with positive staining for cyclin D1 and ki67 as well as neutrophil counts. EGFR exon 20 insertions were detected in 14 (87.5%) IP samples and no EGFR mutations were found in contralateral NP sample. Our study demonstrated distinct inflammatory pattern between IP and contralateral NP and implied the oncogenic role of neutrophils in the pathogenesis of IP. EGFR mutations may be the early event to initiate IP development by enhancing epithelial cell proliferation.

Metastatic ameloblastoma with postoperative accelerated tumor growth treated with carboplatin and paclitaxel: a case report

Ameloblastoma is a histologically benign odontogenic epithelial tumor that rarely metastasizes. However, metastasis to the lungs can occur, usually years after the development of the primary tumor. Here, we present the case of a 63-year-old woman with metastatic ameloblastoma in the lungs that developed 12 years after surgery for the primary lesion. As is typical for metastatic ameloblastomas, the tumor was incidentally found on radiography and surgically removed. However, the tumor exhibited accelerated progression with pleural metastasis after surgical removal, which is unusual in metastatic ameloblastoma. The patient was successfully treated with carboplatin/paclitaxel and showed a partial response to tumor progression, implying that this approach can be safely used in the absence of a standard treatment regimen.

Surgical Margins for Ameloblastoma in Dogs: A Review With an Emphasis on the Future.

Ameloblastoma is a benign epithelial odontogenic tumor with the capacity to aggressively invade the surrounding bone. Surgical removal of the tumor can result in extended disease-free interval (cure). However, controversy surrounds the most appropriate surgical margin required to prevent local recurrence while simultaneously minimizing morbidity. En bloc excisional surgery carries the risk of major complications such as mandibular drift, hemorrhage, and oronasal fistula formation. Conservative therapy without a safety margin reduces potential morbidity but is likely to result in local recurrence. No reliable rate, nor time to recurrence, is documented but may be as high as 91% with conservative therapy. Conversely, surgery with a 10- to 20-mm margin is associated with a 0–4.6% recurrence rate. There is no documented difference in the recurrence rate with a 10- vs. 20-mm margin. The correlation of the histologic margin with the recurrence rate following excisional surgery has not determined a required histologic safety margin. Rather, no local recurrence occurs despite narrow or incomplete margins. Thus, pathologic margins > 0 mm may be sufficient to prevent local recurrence or recurrence may be protracted. Accordingly, a narrow (5–10 mm) gross surgical margin may be the most appropriate. Additional research is required for confirmation, and only level 4 evidence on safety margins has been achieved thus far. Future work should focus on defining the extension of neoplastic cells past the demarcation of ameloblastoma on variable diagnostic imaging modalities as well as determining the recurrence rate with various surgical and histologic safety margins.