Case Of Ameloblastoma Research Articles

A Retrospective Radiologic Analysis of the Treatment Outcomes of Ameloblastomas

ABSTRACTIntroductionThe current study reviewed the postoperative radiologic findings of 156 cases of ameloblastoma diagnosed at a tertiary institution in South Africa.MethodsHistologically diagnosed cases of ameloblastomas between 2012 and 2022 were retrospectively reviewed. Only cases with both pre‐ and postoperative radiographs of diagnostic quality were included in the study. The demographics, treatment and follow‐up radiologic findings, including recurrences, were assessed. This clinical data was collected from all available patient records and histopathologic reports.ResultsSeventy‐nine cases of ameloblastoma (50.97%) diagnosed at the institution had post‐treatment radiographs available and were included in the study for further analysis. Conservative treatment, including marsupialisation and/or enucleation, was performed in 11 cases (13.92%). The recurrence rate for conservatively treated cases was 44.4% after a mean follow‐up of 31.4 months. Tumour resection was performed in 72 cases (91.1%), including 4 recurrent cases previously treated conservatively. Tumour recurrence was only noted in 4 cases (7.5%) treated via surgical resection after a mean follow‐up of 25 months. Spontaneous bone regeneration was seen in 19 cases (35.8%) of ameloblastomas treated via surgical resection.ConclusionAmeloblastomas are benign neoplasms with high recurrence rates, emphasising the need for appropriate treatment and extended follow‐up periods. The high recurrence rate reported in cases of ameloblastoma managed conservatively highlighted its inappropriate use in treating conventional subtypes. The presence of bony regeneration in this study was higher than the reported literature, correlating with the overall younger age of the current sample.

Emergency Open Appendectomy Under Continuous Lumbar Epidural Anesthesia in a Patient with Massive Ameloblastoma

Background: Open appendectomy is still performed in the Philippines. The choice of anesthetic technique should tailor the patient's profile and the disease’s extent. This case presents a unique scenario involving a patient with a known case of ameloblastoma, complicating her anesthetic management Method: A 29-year-old female presented with migratory abdominal pain associated with symptoms of acute appendicitis. She was scheduled for an emergency open appendectomy under continuous lumbar epidural anesthesia, selected for its advantage in providing reliable surgical anesthesia in a probable prolonged surgery. Result: Epidural anesthesia provided adequate sensorimotor blockade during the three-hour surgery. Patient had an uneventful postoperative course and was discharged two days after the operation. This case presents the need for tailored anesthetic approaches in managing patients with unique medical histories undergoing common surgical procedures. These findings contribute to the limited studies on open appendectomy under continuous lumbar epidural anesthesia in a patient with massive ameloblastoma.

Expression of ALKBH5 in Odontogenic Lesions.

N6-methyladenosine (m6A) is the most abundant epigenetic RNA modification in eukaryotes and plays a role in various cancers in humans. This m6A modification is regulated by m6A writers, erasers, and readers. One of the m6A erasers is α-ketoglutarate-dependent dioxygenase homolog 5 (ALKBH5). Previous studies have suggested that ALKBH5 is involved in the pathogenesis of head and neck squamous cell carcinoma. However, the role of ALKBH5 in odontogenic lesions has never been investigated. This study aimed to examine ALKBH5 expression in dental follicles (DFs), dentigerous cysts (DCs), odontogenic keratocyst (OKC), and ameloblastoma (AM) using immunohistochemistry. Six cases of DF, 20 cases of DC and OKC, respectively, and 30 cases of AM were included. The expression patterns, percentage of ALKBH5-positive cells, staining intensities, and immunoreactive scores were examined. ALKBH5 was mainly expressed in the nuclei of the epithelial cells in odontogenic lesions. The percentage of ALKBH5-positive cells was significantly higher in OKC and AM samples compared with DF samples (P < 0.01). The percentage of ALKBH5-positive cells was also higher in OKC and AM samples than in DC samples; however, these results did not show statistical significance (P > 0.05). ALKBH5 cell staining intensities and immunoreactive scores were significantly greater in OKC and AM samples than in DF and DC samples (P < 0.01). Our results suggested that ALKBH5 might play a role in the pathogenesis of odontogenic lesions. Further investigation is needed to elucidate the precise molecular mechanism of the role of ALKBH5 in these diseases.

Peripheral Ameloblastoma: A rare case of soft tissue tumor (Case Study)

A rare case of Peripheral ameloblastoma (PA) is reported. This rare type of tumor, classified as benign, locally invasive odontogenic tumor which histologically resembles an intraosseous ameloblastoma but develops in the soft tissues of the gingiva and mucosa. The prevalence of PA ranging from 2-10% compared to the other types of ameloblastoma. A case of PA in a 56-years-old male with an exophytic painless mass in the gingiva of the anterior mandible provisionally diagnosed as irritation fibroma is reported. Histopathological result of surgical treatment was concluded as acanthomatous peripheral ameloblastoma. Based on this experience clinical manifestation of gingival tumor a careful diagnosis should be taken by included the PA in differential diagnosis, in order to manage an adequate treatment and to ovoid of tumor recurrent.

Unicystic Ameloblastoma Masquerading as Vascular Lesion

Ameloblastoma is a benign epithelial tumor of odontogenic origin which shows variations in its presentation that intrigue the authors. Authors report a case of unicystic ameloblastoma which presented, clinically and radiographically mimicking features of a vascular lesion. Patient reported with the chief complaint of pain and swelling in the left lower-third of the face. The investigations performed gave a diagnosis dilemma and hence deciding on appropriate investigations played a pivotal role to enable precise diagnosis of the lesion and facilitated surgeons to decide on the treatment plan.

Maxillary Acanthomatous Ameloblastoma in Dog: Case Report

This report aims to describe a case of acanthomatous ameloblastoma in the central region of the left maxilla in a dog that had a history of sialorrhea and hyporexia. A 12-year-old Shih Tzu dog weighing 5 kg was treated at a veterinary clinic specializing in veterinary dentistry. The animal had an increase in volume in the left maxilla caused by a pink mass with irregular contours. The animal had difficulty eating and was progressively losing weight. Imaging tests revealed a neoplastic growth and displacement of the teeth affected by the tumor mass, without bone involvement. In the histopathological examination the gingival cells were polygonal in shape with broad, eosinophilic cytoplasm, with distinct borders and evident desmosomal junctions, arranged in a palisade or perpendicular to the basement membrane, being compatible with acanthomatous ameloblastoma. The treatment of choice was surgical removal. In the postoperative evaluation the dog presented dehiscence of the suture and underwent reintervention to perform a new suture. In the immediate postoperative period, the animal remained active. Although adult dogs, of medium to large size, are the most affected by this type of tumor, this work demonstrates that small breeds can also develop the disease. The location of the tumor reported here also differs from that commonly reported in the literature. The full recovery of patients affected by acanthomatous ameloblastoma will depend on the ability to perform an appropriate clinical-surgical approach, seeking excision of the tumor with free margins and correct postoperative follow-up.

RESSECÇÃO DE AMELOBLASTOMAS CONVENCIONAIS APÓS TRATAMENTO CONSERVADOR E RELATO DE TRANSFORMAÇÃO PERIFÉRICA: SÉRIE DE CASOS E REVISÃO INTEGRATIVA

Introduction: Ameloblastoma is a slow-growing tumor, presenting bone expansion and high recurrence rates. It originates from the tooth enamel, dental follicle, periodontal ligament or lining of odontogenic cysts and odontogenic epithelium. Recently, in 2022, the WHO reclassified ameloblastomas into conventional, unicystic, peripheral and metastatic due to prospective views based on updates to genetic studies, which has generated a dilemma in the literature regarding the ideal therapeutic approach for conventional ameloblastoma, to provide a lower surgical risk and morbidity to patients. Purpose: Carry out an integrative review of the literature, describing 02 resections of conventional ameloblastomas after conservative treatment and 01 report of peripheral transformation, providing valuable information on management. Methodology: The current study was divided into two stages. The first step consists in a descriptive series of three cases of conventional ameloblastomas treated by conservative methods, where two of them were subsequently submitted to partial resection and the third one turned into a peripheral ameloblastoma. In the second step, an integrative and systematic review was carried out in accordance with the PRISMA recommendations on resection and excision for treating conventional ameloblastomas. Results: Classification and treatment methods in cases of ameloblastoma are based on histopathological characteristics and can range from enucleation to resection with reconstruction. This study focuses on three case reports of patients with conventional ameloblastoma. The treatment consisted in two partial resections with primary reconstructions and one enucleation combined with a peripheral osteotomy after conservative treatments without prolonged follow-up. The treatment of choice and recurrence were evaluated, and the patients had satisfactory results. Conclusion: There is no consensus on the treatment of ameloblastomas. Both conservative surgeries and radical interventions are used. The chosen treatment must take into account the location of the tumor, size, age, general health condition and cooperation of the patient, possibility of long-term delivery, histopathological pattern and professional experience.

Ameloblastoma Cases in the Mandible: Experience from the Professor Hamady Traoré National Center of Odonto-Stomatology of Bamako

Introduction: Mandibular ameloblastoma is the most common benign odontogenic tumour in stomatological and maxillofacial surgery practice. The aim of this work was to study the epidemiological, anatomopathological and therapeutic aspects of mandibular ameloblastoma in our context. Methodology: It was a descriptive cross-sectional study over a 4-year period (January 2017 to December 2020) of cases of mandibular ameloblastoma confirmed by histology of the operative specimen in the stomatology and and maxillofacial surgery department of the CHU-CNOS in Bamako. Data were collected on a survey form, entered and analyzed using SPSS version 19.0 software. Results: There were 44-recorded cases. Males accounted for 61.36% of cases, with an M/F sex ratio of 1.6. The mean age was 33 years, with a standard deviation of 12 years. The 20-40 age bracket was in the majority (52.27%). In 79.55% of cases, patients consulted for swelling with facial deformity. Dental signs such as mobility, displacement or absence were found in 97.72% of cases. Hemi-mandibular location was the most frequent (45.45%). The main histological type was follicular ameloblastoma in 88.64% of cases. Radical surgery with disarticulation was performed in 47.73% of cases. Conclusion: Mandibular ameloblastoma is common in young adults. Radical surgery is the current trend. Reconstructive techniques are still limited in a context of underdevelopment.

Plexiform Variant of Ameloblastoma in Body of Mandible: Case Report and Review of Literature

Ameloblastoma is a benign but locally aggressive odontogenic epithelial neoplasm arising from remnants of dental lamina and dental organ [1,4]. This neoplasm is more prevalent between 2nd to 4th decade of life and mandible (11%) is more commonly involved than maxilla (1%) [2,5]. It has an aggressive behavior and recurrent course, It is rarely metastatic. Ameloblastoma represents 10% of odontogenic tumors and 1% of all tumors and cysts involving the maxillo mandibular region [1]. The World Health Organization (WHO) classification of 2017 describes ameloblastomas of the following four types: Solid/multicystic ameloblastoma (91%) unicystic ameloblastoma (6%); extraosseous/peripheral ameloblastoma (2%); and metastasizing ameloblastoma (1%). [3,8] A conclusive diagnosis can only be made by histopathology because it has wide range of histologic patterns and has radiographic characteristics with other lesions such the odontogenic keratocyst, giant cell tumour, aneurysmal bone cyst, and renal cell carcinoma metastasis.[5] Treatment for each type of ameloblastoma differs depending on its biological behaviour and rate of recurrence. This report presents a case of ameloblastoma involving the body of mandible with resorption of the root apices of canine, premolars and first molar. The lesion extends till the base of mandible with intact lower border. This was surgically excised preserving the lower border of mandible with safe sound margins of bone.

Expression of Fascin and SALL4 in odontogenic cysts and tumors: an immunohistochemical appraisal.

Background Various stemness markers (SOX2, OCT4, and NANOG) have been studied in odontogenic cysts and tumors. However, studies on SALL4 having similar properties of stemness has not been documented. Additionally, insight into fascin as a migratory molecule is less explored. In this study, the expression of SALL4 and fascin were evaluated in ameloblastoma, adenomatoid odontogenic tumor (AOT), odontogenic keratocyst (OKC), dentigerous cyst (DC), radicular cyst (RC), and calcifying odontogenic cyst (COC). Methods Semi-quantitative analysis of fascin and SALL4 immuno-positive cells was done in a total of 40 cases of ameloblastoma (11 plexiform, 12 follicular, 12 unicystic, and 5 desmoplastic) variants, 6 cases of AOT, 15 each of OKC, DC, RC and 5 of COC. Chi-square test was applied to evaluate the association between SALL4 and fascin expression in odontogenic cysts and tumors. Results Fascin immunopositivity was observed in peripheral ameloblast-like cells, and the expression was weak or absent in stellate reticulum-like cells. A moderate to weak immune-reactivity to SALL4 was observed in the cytoplasm of ameloblastoma, epithelial cells of dentigerous and radicular cysts, having a marked inflammatory infiltrate, which was an interesting observation. COC and AOT had negative to weak expressions. No recurrence has been reported. Conclusions Expression of fascin in ameloblastomas elucidate their role in motility and localized invasion. Its expression in less aggressive lesions like DC, COC, AOT will incite to explore the other functional properties of fascin. SALL4 expression in the cytoplasm of odontogenic cysts and tumors may represent inactive or mutant forms which requires further validation.

Expression of Fascin and SALL4 in odontogenic cysts and tumors: an immunohistochemical appraisal.

Background Various stemness markers (SOX2, OCT4, and NANOG) have been studied in odontogenic cysts and tumors. However, studies on SALL4 having similar properties of stemness has not been documented. Additionally, insight into fascin as a migratory molecule is less explored. In this study, the expression of SALL4 and fascin were evaluated in ameloblastoma, adenomatoid odontogenic tumor (AOT), odontogenic keratocyst (OKC), dentigerous cyst (DC), radicular cyst (RC), and calcifying odontogenic cyst (COC). Methods Semi-quantitative analysis of fascin and SALL4 immuno-positive cells was done in a total of 40 cases of ameloblastoma (11 plexiform, 12 follicular, 12 unicystic, and 5 desmoplastic) variants, 6 cases of AOT, 15 each of OKC, DC, RC and 5 of COC. Chi-square test was applied to evaluate the association between SALL4 and fascin expression in odontogenic cysts and tumors. Results Fascin immunopositivity was observed in peripheral ameloblast-like cells, and the expression was weak or absent in stellate reticulum-like cells. A moderate to weak immune-reactivity to SALL4 was observed in the cytoplasm of ameloblastoma, epithelial cells of dentigerous and radicular cysts, having a marked inflammatory infiltrate, which was an interesting observation. COC and AOT had negative to weak expressions. No recurrence has been reported. Conclusions Expression of fascin in ameloblastomas elucidate their role in motility and localized invasion. Its expression in less aggressive lesions like DC, COC, AOT will incite to explore the other functional properties of fascin. SALL4 expression in the cytoplasm of odontogenic cysts and tumors may represent inactive or mutant forms which requires further validation.

Neuroectodermal influence in odontogenic cyst and tumor: evidence through CD56 immunoexpression.

CD56, associated with neuroectodermal differentiation of the embryonal cells, is often considered a marker of neural lineage. Odontogenic keratocysts (OKCs) are of particular interest because of their characteristic histopathologic features, high recurrence rate, and aggressive behavior. CD56 immunoreactivity in these lesions has been reported with very high frequency. The present study analyzes the immunoexpression of CD56 in ameloblastoma (AM) and OKC to infer neuroectodermal influence in the pathogenesis of odontogenic lesions and its correlation with clinicopathologic parameters. Fifty histopathologically confirmed cases of OKC and AM, 25 from tooth-bearing (TB) and molar-ramus (MR) regions each, and 5 dental follicular tissues as control were collected from the department archives and immunohistochemical analysis with CD56 was carried out. CD56 immunopositivity was seen in 64% AM and 36% OKC cases. The majority of AM cases showed cytoplasmic expression in the peripheral cells of odontogenic islands; similarly, OKC cases showed continuous and uniform cytoplasmic expression in the basal and parabasal cells of the cystic lining. CD56 immunopositivity was found in more AM cases as compared to OKC cases in both the TB and MR regions. The assessment of CD56 immunoexpression in odontogenic cyst and tumor (AM) may aid in understanding the role of neuroectodermal influence in the etiopathogenetic pathways and a possible influence of CD56 on the clinical behavior and aggressiveness of the odontogenic lesions. A correlation of CD56 expression with the clinical outcome of the disease (site, perforation, root resorption, and tooth displacement) can help envisage possible prognostic assessment for these lesions.

Evaluation of Paxillin Expression in Odontogenic Cysts and Tumors.

Paxillin (PXN) is one of the proteins involved in cell adhesion. PXN and integrins constitute a key site for the focal adhesion between the cell and extracellular matrix. Several studies have shown that PXN is a factor in tumor formation, progression, invasion, and metastasis. This study evaluated PXN expression in four types of odontogenic lesions with different aggressive behaviors. In this retrospective cross-sectional study, PXN expression was immunohistochemically assessed in 68 paraffin-embedded tissue samples from patients with the confirmed diagnosis of four types of odontogenic lesions, including 14 dentigerous cysts (DC), 20 odontogenic keratocyst (OKC), 16 unicystic ameloblastoma, and 18 solid ameloblastoma. The PXN expression in these samples were scored based on the percentage and intensity of immunoreactivity, and compared among the groups by Chi-square test. The PXN marker was detected in the cytoplasm of tumor cells (unicystic and solid ameloblastoma) and the epithelial layer of cysts (DC and OKC). The intensively stained marker of PXN was observed in 9 cases (64.3%) of the DC, 14 cases (70%) of OKC, 12 cases (75%) of unicystic ameloblastoma, and 13 cases (72.2%) of solid ameloblastoma. However, there was not statistical difference of PXN protein expression between DC and OKC (p Value = 0.51) and unicystic and solid ameloblastoma (p = 0.58), also the same was true for cysts and tumors (p = 0.37). The expression of PXN is not related to the biological behaviors of odontogenic lesions.

Application of mixed reality technology in free fibular flap transplantation for repairing mandibular defects

To explore the feasibility and effectiveness of mixed reality technology for localizing perforator vessels in the repair of mandibular defects using free fibular flap. Between June 2020 and June 2023, 12 patients with mandibular defects were repaired with free fibular flap. There were 8 males and 4 females, with an average age of 61 years (range, 35-78 years). There were 9 cases of ameloblastomas and 3 cases of squamous cell carcinomas involving the mandible. The disease duration ranged from 15 days to 2 years (median, 14.2 months). The length of mandibular defects ranged from 5 to 14 cm (mean, 8.5 cm). The area of soft tissue defects ranged from 5 cm×4 cm to 8 cm×6 cm. Preoperative enhanced CT scans of the maxillofacial region and CT angiography of the lower limbs were performed, and the data was used to create three-dimensional models of the mandible and lower limb perforator vessels. During operation, the mixed reality technology was used to overlay the three-dimensional model of perforator vessels onto the body surface for harvesting the free fibular flap. The length of the fibula harvested ranged from 6 to 15 cm, with a mean of 9.5 cm; the size of the flap ranged from 6 cm×5 cm to 10 cm×8 cm. The donor sites were sutured directly in 7 cases and repaired with free skin grafting in 5 cases. Thirty perforator vessels were located by mixed reality technology before operation, with an average of 2.5 vessels per case; the distance between the exit point of the perforator vessels located before operation and the actual exit point ranged from 1 to 4 mm, with a mean of 2.8 mm. All fibular flaps survived; 1 case had necrosis at the distal end of flap, which healed after dressing changes. One donor site had infection, which healed after anti-inflammatory dressing changes; the remaining incisions healed by first intention, and the grafts survived smoothly. All patients were followed up 8-36 months (median, 21 months). The repaired facial appearance was satisfactory, with no flap swelling. Among the patients underwent postoperative radiotherapy, 2 patients had normal bone healing and 1 had delayed healing at 6 months. In free fibular flap reconstruction of mandibular defects, the use of mixed reality technology for perforator vessel localization can achieve three-dimensional visualization, simplify surgical procedures, and reduce errors.

Frequent mutation of K-RAS in addition to BRAF V600E in Ameloblastoma – An immunohistochemical study

BackgroundAmeloblastoma is the most frequently encountered, enigmatic odontogenic tumor whose etiopathogenesis is still controversial. Understanding the pathogenic mechanism involved in Ameloblastoma and its proliferation aids in determining the best treatment option at an early stage. MAPK pathway are known to be active during tooth development, and also mutations in MAPK components have been identified in both benign and malignant tumors. The aim of this study was to evaluate the Immunohistochemical expression of biomarker BRAF V600E and K-RAS in Ameloblastoma and to examine if any, correlation exists between BRAF V600E and K-RAS expression. Methods30 formalin-fixed paraffin-embedded blocks of histopathologically diagnosed cases of Ameloblastoma were taken as samples. Immunohistochemistry using K-RAS and BRAF V600E antibody was performed and slides were evaluated both quantitatively and qualitatively using a quick score by an independent observer. ResultsK-RAS and BRAF V600E immunoexpression was evaluated and there is a significantly higher expression of K-RAS (mean score 6.20 ± 1.883) when compared with BRAF V600E (mean score 4.50 ± 2.271). BRAF V600E and K-RAS act independently in the pathogenesis of Ameloblastoma as the pattern of variation of BRAF V600E score was uneven when compared to K-RAS values. ConclusionOur data provide evidence that two independent mutation occurs in the same molecular pathway driving Ameloblastomas. But there is no correlation between K-RAS and BRAF V600E expression. Hence, combination therapy of K-RAS and BRAF V600E inhibitors can be helpful for the treatment of Ameloblastoma.

SURGICAL MANAGEMENT OF DESMOPLASTIC AMELOBLASTOMA: CONSERVATIVE OR RADICAL APPROACH

Ameloblastoma is a benign odontogenic tumor of epithelial origin. It is locally aggressive with unlimited growth capacity and a high potential for malignant transformation and metastasis. (1) Nowadays, there are two opposing approaches to the surgical management of ameloblastoma. The conservative approach consists of enucleation and/or curettage and the radical approach consists of bone resection with margins of at least 1cm (segmental or not). (2) In this work, we will present a case of desmoplastic ameloblastoma diagnosed in 2014. The patient had been benefiting from regular follow-up. However, a recurrence occurred in 2021. This paper delves into our experiences in managing desmoplastic ameloblastoma, initially employing a conservative approach in 2014 and later transitioning to a radical approach in 2021 in response to the recurrence.

A Hybrid Ameloblastoma in Posterıor Mandible: A Case Report

Objective: Hybrid ameloblastoma refers to the tumors that contain two or more different histologic types of ameloblastoma. Till date, only 49 cases of hybrid ameloblastoma with different combinations have been reported. Here we present a case of hybrid ameloblastoma containing follicular, plexiform, and acanthomatous types. Case Report: A 24-year-old male patient referred to our clinic with a slow-growing asymptomatic swelling on the right side of the mandible. Radiographic assessment revealed a well-defined radiolucent lesion associated with an impacted third molar. Following incisional biopsy, which was compatible with ameloblastoma, total excision of the lesion along with Carnoy fixation was performed. Final histopathologic assessment revealed a hybrid ameloblastic lesion which contained follicular, plexiform, and acanthomatous types. Conclusion: Hybrid ameloblastoma has variable clinical, radiological, and histopathological presentation. As a rare entity, the biological behavior of the lesion still needs to be analyzed extensively with further clinical research. Keywords: Carnoy, Enucleation, Hybrid ameloblastoma.

Low Detection of High-risk Human Papilloma Virus in Individuals with Ameloblastoma in a Tertiary Hospital in Lagos, Nigeria.

Ameloblastoma is a benign but aggressive epithelial odontogenic neoplasm of unknown etiology. The role of human papilloma virus (HPV) in the etiology of oral squamous cell carcinoma has prompted the investigation of HPV as an etiologic factor in ameloblastoma. This study aimed to determine the frequency of high-risk (HR) HPV in conventional ameloblastoma and the clinical parameters associated with infection. The study was approved by the ethical review boards of the institution. DNA was extracted from fresh tissue collected 750 μL of DNA/RNA Shield (Zymo Research, United States) using Invitrogen PureLink Viral RNA/DNA Mini Kit (Invitrogen, USA). The extracted DNA was assayed for the detection of 14 HR HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) using Anyplex™ II HPV HR Detection kit (Cat. No. HP7E00X) (Seegene Inc., Republic of Korea) on CFX-96TM Real-Time Polymerase Chain Reaction (PCR) System (Bio-Rad). Data on gender, age of patient, site of lesion, clinicohistological types of ameloblastoma and history of smoking, alcohol consumption, and practice of oral sex were collected. Data analysis was performed using analysis program SPSS version 25 and statistical significance was set at P < 0.05. Two cases of conventional ameloblastoma were positive with HPV and none of the ameloblastic carcinoma cases were positive. The HPV 16 serotype was observed in both cases. While 5 of the cases had a history of alcohol consumption, none of these cases were positive for HPV serotype. HPV 16 positivity was detected in two cases of conventional ameloblastomas and none in ameloblastic carcinoma using real-time PCR. There was no effect of exposure to smoking, alcohol consumption, and practice of oral sex and HPV in the etiology of ameloblastoma. Data available are suggestive of a limited role of HPV in the etiology of ameloblastoma.

Demographics and Pathomorphology of Ameloblastoma: A 9 Year Retrospective Review at a Tertiary Health Care Centre in North-Central Nigeria

Ameloblastoma is a benign but locally invasive neoplasm that arises from odontogenic epithelium of the dental lamina. It is classified into the conventional, unicystic, extraosseous/peripheral and metastasizing variants. It is the most common odontogenic tumour in Nigeria and other developing countries. It affects individuals of all ages, has a peak of occurrence in the fourth and fifth decades with no sex predilection. The Mandible is the most commonly affected site and the conventional variant is predominant. The aim of this study is to document the demographics and Pathomorphology of ameloblastoma diagnosed at the Jos University Teaching Hospital over the past nine years. There is no previous documentation of the pattern of this tumour in the North-central region of Nigeria making this study relevant. This is a retrospective observational review of all cases of ameloblastoma diagnosed histologically at the Jos University Teaching Hospital between January 1st 2015 to December 31st 2023. Materials utilized consisted of patient clinical case files, electronic histopathology result records, histopathology glass slides and formalin fixed paraffin embedded tissue blocks. The patient age, sex, anatomic location of tumour in the Jaw/face and pathomorphological features were recorded for all cases. The data obtained was analysed using Epi-info 7 (version 3.5.4) and Microsoft-Excel. Results were presented in tables and charts. Fifty one cases of ameloblastoma were diagnosed during the 9 years of review. Their ages ranged between 6 and 65 years with a mean age of 30.9±13.8 years and a peak of occurrence in the third decade. There were 29 males and 22 females with a male to female ratio (M:F) of 1.3:1. Ninety-two percent of cases occurred in the mandible and 8% in the maxilla. The conventional variant accounted for 72.5% of cases and the unicystic variant 27.5%. The follicular type accounted for 64.8% of cases of conventional ameloblastoma. Ameloblastoma occurred more commonly in males with a peak in the third decade. A vast majority of cases involved the mandible and the conventional type was predominant. This demographic pattern supports existing evidence that ameloblastoma occurs more commonly in males and in relatively younger patients in Africa.

A Retrospective Analysis of 129 Ameloblastoma Cases: Clinical and Demographical Trends from a Single Institution.

A retrospective chart review of patients evaluated for ameloblastoma between 2010 and 2020 at a single tertiary care center. Age, race, sex, tumor size, tumor location, and histological subtypes were recorded. A total of 129 cases of ameloblastoma were recorded with a mean patient age of 42 ± 18.6 years (range 9-91 years old), male to female ratio 1.08:1. Ameloblastoma presenting in the mandible outnumbered maxilla in primary (118 to 8, respectively) and recurrent cases (8 to 1, respectively). There was a higher prevalence of ameloblastoma in Black patients (61.3%) with mean age of Black patients occurring at 40.5 years and the mean age of White patients occurring at 47.8 years and mean tumor size trended larger in the Black patients (15.7 cm2) compared to White patients (11.8 cm2). Data suggests a strong influence of racial factors on the incidence of ameloblastoma, with regards to size, Black patients with ameloblastoma trended higher and more data is needed to clearly elucidate any relationship between the tumor size and race, as other factors may influence the size (such as time to discovery).