Diagnosis Of Ameloblastoma Research Articles

A Challenging Case Of Giant Maxillary Ameloblastoma: Navigating Rarity And Complexity In Diagnosis And Treatment

Background: Ameloblastoma is a rare, aggressive, benign odontogenic tumor that most commonly occurs in the jaw. Maxillary occurrences are rarely reported. Case Presentation: We report the case of a 61-year-old male presenting with right-sided unilateral nasal obstruction, characterized by a mass occupying the entire right nasal fossa upon anterior rhinoscopy. A computed tomography (CT) scan, combined with magnetic resonance imaging (MRI), revealed a locally advanced mass centered on the right maxillary sinus. The patient underwent wide excision of the mass, and histopathological analysis confirmed the diagnosis of ameloblastoma. Discussion: Naso-sinus ameloblastomas are rare, benign, and slow-growing tumors, accounting for approximately 0.11% of nasal and sinus tumors. More common in men, they typically present between the ages of 20 and 30. Symptoms include nasal obstruction and epistaxis, with occasional facial swelling or headaches. These tumors often originate in the posterior maxillary region and extend into the maxillary sinuses and nasal cavity. Diagnosis is facilitated by imaging, where the tumors appear as solid, radio-opaque masses. Radical surgical resection is the preferred treatment, as it is essential for preventing recurrence. The prognosis is generally favorable, with no documented cases of malignant transformation or metastasis, and recurrences are rare when appropriate surgical management is performed. Conclusion: Medical imaging plays a crucial role in diagnosis and allows for the evaluation of tumor dissemination and anatomical involvement. The treatment of maxillary ameloblastoma typically involves surgical excision, with the complexity of management often linked to the extent of tumor spread.

Ameloblastoma radiographic imaging on 3D CBCT: a literature review

Objectives: This review article is aimed to provide an overview of 3D CBCT in determining the diagnosis of ameloblastoma. Review: This study is a literature review consisting of English articles about the ameloblastoma radiographic imaging on 3D CBCT, published 2013-2023.The article search databases used were Google scholar, Ebsco, Pubmed .The total search results for articles based on keywords obtained were 552 articles, and only 9 articles were include. Ameloblastoma is a persistent and locally invasive tumor; with aggressive but docile growth characteristics. Ameloblastoma is generally associated with impacted teeth, so it requires a more detailed radiographic examination. Computed cone-beam tomography (CBCT) is a more advantageous imaging system with a lower radiation dose and smaller area requirements. 3D CBCT is a radiographic examination with a high modality, so it is very important in helping to establish a diagnosis, especially for cases that show radiographic differences. Ameloblastoma is divided into several types based on the radiological picture. Odontogenic Keratosis Cysts and ameloblastoma may exhibit similar radiographic features, which make diagnosis difficult. Conclusion: 3D CBCT examination is helpful in diagnosing and validating the treatment of ameloblastoma.

Application of machine learning in the preoperative radiomic diagnosis of ameloblastoma and odontogenic keratocyst based on cone-beam CT

Abstract Objectives Preoperative diagnosis of oral ameloblastoma (AME) and odontogenic keratocyst (OKC) has been a challenge in dentistry. This study uses radiomics approaches and machine learning (ML) algorithms to characterize cone-beam CT (CBCT) image features for the preoperative differential diagnosis of AME and OKC and compares ML algorithms to expert radiologists to validate performance. Methods We retrospectively collected the data of 326 patients with AME and OKC, where all diagnoses were confirmed by histopathologic tests. A total of 348 features were selected to train six ML models for differential diagnosis by a 5-fold cross-validation. We then compared the performance of ML-based diagnoses to those of radiologists. Results Among the six ML models, XGBoost was effective in distinguishing AME and OKC in CBCT images, with its classification performance outperforming the other models. The mean precision, recall, accuracy, F1-score, and area under the curve (AUC) were 0.900, 0.807, 0.843, 0.841, and 0.872, respectively. Compared to the diagnostics by radiologists, ML-based radiomic diagnostics performed better. Conclusions Radiomic-based ML algorithms allow CBCT images of AME and OKC to be distinguished accurately, facilitating the preoperative differential diagnosis of AME and OKC. Advances in knowledge ML and radiomic approaches with high-resolution CBCT images provide new insights into the differential diagnosis of AME and OKC.

Follicular Ameloblastoma of Maxillary: A Case Report

Introduction: Ameloblastoma is a benign odontogenic tumor that appears in the mandible and maxilla. Ameloblastoma has slow growth that takes several years for symptoms to appear, but ameloblastoma in the maxilla has a more aggressive clinical course compared to the mandible. The lack of initial symptoms leading to diagnosis at an advanced disease when the tumour has already extended beyond maxilla. The cancellous structure of the maxillary bone makes it easier for tumors to spread to the nasal cavity, paranasal sinuses, orbitals, parapharyngeal tissue and skull base. This article reports a case of resection of maxillary ameloblastoma. Case Report: A 63 year old female patient came with complaints of a lump on her right cheek since 2 years back that gradually increased in size. Since 2 months ago, pus and blood have been coming out of the lump. Extra oral examination revealed a well-defined mass with a solid and hard consistency, there were no ulcers or fistulas. Intraorally, a mass measuring 5x5x3cm was found in the region of teeth 12 to 15 which extended to the buccal-palatal area. History of allergies and weight loss was denied. Supporting examinations including panoramic radiography, PA chest radiography, CT-Scan, FNAB, and biopsy resulted in a diagnosis of ameloblastoma. Treatment was carried out by resection of the right maxillary tumor mass under general anesthesia. Discussion: In this case, the patient's clinical examination showed a hard and large palpable swelling in the right maxilla area which extended from the region of tooth 12 to tooth 15 which caused facial asymmetry and no tooth mobility was found. This hard and painless swelling takes about 2 years before the patient experiences symptoms of pus and blood discharge. The post-maxillectomy defect in this case was covered with an intraoral prosthesis in the form of a post-surgical obturator made of acrylic resin. The obturator functions to hold the surgical packing, and prevent food or dirt contamination in the defect area which can cause infection and slow healing. The use of a prosthesis also helps restore swallowing and speech function to the patient. Conlussion: In principle, the treatment for ameloblastoma is resection of the involved bone, as in this case the action taken is a maxillectomy. Maxillectomy can result in facial and oral cavity deformities characterised by facial disfigurement and alterations in oral functionality.Therefore, maxillary reconstruction is needed to treat maxillary defects after surgical procedures involving the loss of part or all of the maxilla.

Unusual Variant of Ameloblastoma with Calcifying Epithelial Odontogenic Tumor-like Areas in a Three-Year Old Child

The Calcifying Epithelial Odontogenic Tumor (CEOT) is a benign odontogenic tumor, comprising approximately 1% of all odontogenic tumors. It presents as a slow-growing tumor in posterior mandibular region. A three year-old female child from Multan, reported a swelling in right lower jaw progressively increasing in size eventually causing facial asymmetry. On intraoral examination, a protuberance was seen arising from posterior mandibular region and causing displacement of overlying teeth. The swelling was cystic on palpation and mildly tender. The patient underwent complete excision of lesion at a tertiary care center in her locality. The excision biopsy specimen was received at our lab which was intact and well preserved. A diagnosis of ameloblastoma with Calcifying epithelial odontogenic tumor-like areas was made. The patient was followed up after six months however no complaint of any recurrent swelling in the area of was recorded.

DNA content and clinicopathological features aid in distinguishing ameloblastic carcinoma from ameloblastoma.

Ameloblastoma and ameloblastic carcinoma are epithelial odontogenic tumors that can be morphologically similar. In the present study, we evaluated the DNA content and Ki-67 index in the two tumors. The paraffin blocks of the tumors were selected to obtain sections for the immunohistochemical reactions and preparation of the cell suspension for acquisition in a flow cytometer. The Random Forest package of the R software was used to verify the contribution of each variable to classify lesions into ameloblastoma or ameloblastic carcinoma. Thirty-two ameloblastoma and five ameloblastic carcinoma were included in the study. In our sample, we did not find statistically significant differences in Ki-67 labeling rates. A higher fraction of cells in 2c (G1) was correlated with the diagnosis of ameloblastoma, whereas higher rates of 5c-exceeding rate (5cER) were correlated with ameloblastic carcinoma. The Random Forest model highlighted histopathological findings and parameters of DNA ploidy study as important features for distinguishing ameloblastoma from ameloblastic carcinoma. Our findings suggest that the parameters of the DNA ploidy study can be ancillary tools in the classification of ameloblastoma and ameloblastic carcinoma.

Brown Tumor, a Deceptive and Rare Entity: A Case Report

A case of 27 years old male from Jhapa district, who presented to Oral and Maxillofacial department of B&C hospital with firm, non-tender swelling over buccal vestibule for 2 months. Computed tomography (CT) revealed an expansile lytic bony lesion with soft tissue component at the right hemimandible with cortical destruction. Provisional diagnosis of ameloblastoma was made. Incisional biopsy done and specimen was sent to the Pathology department. Haematoxylin and Eosin- stained slides revealed disorderly, fascicular architecture exhibiting clustered distribution of osteoclastic giant cells, surrounded by fibroblastic stromal cells along with reactive new bone formation. The differentials considered were CGCG (Central giant cell granuloma), GCT (Giant Cell tumor), ABC (Aneurysmal Bone Cyst) and Brown tumor. Serum Calcium and Serum PTH (Parathyroid hormone) were advised to ruleout brown tumor in histopathology report and for rest of the differentials excisional biopsy was suggested. Serum calcium and serum PTH were found to be raised. On further probing, the patient has been having right lower back pain and thin urine stream on and off for few months. USG abdomen was done for the same which revealed bilateral nephrolithiasis with left sided PUJ calculus causing gross hydronephrosis along with bilateral medullary nephrocalcinosis. DJ stenting was thus advised by the nephrologist. On identifying the primary cause, hemithyroidectomy with parathyroid removal was done. The decrease in parathyroid hormone level was drastic after the surgery. His urine stream was normal during his post –op stay at the hospital. The patient was advised for regular follow up.

Central mucoepidermoid carcinoma of the mandible: a case report

Mucoepidermoid carcinoma is the most common malignant tumour of the salivary glands. It usually occurs in the parotid glands. Primary intraosseous mucoepidermoid carcinoma is rare, making up 2-3% of all mucoepidermoid carcinoma. They usually affect the mandible, with the common clinical presentation being jaw swelling. We report a case of a primary intraosseous mucoepidermoid carcinoma in a 48-year-old African male, who was managed surgically by left hemimandibulectomy, on account of a provisional diagnosis of ameloblastoma.

Deep learning applied to the histopathological diagnosis of ameloblastomas and ameloblastic carcinomas.

Odontogenic tumors (OT) are composed of heterogeneous lesions, which can be benign or malignant, with different behavior and histology. Within this classification, ameloblastoma and ameloblastic carcinoma (AC) represent a diagnostic challenge in daily histopathological practice due to their similar characteristics and the limitations that incisional biopsies represent. From these premises, we wanted to test the usefulness of models based on artificial intelligence (AI) in the field of oral and maxillofacial pathology for differential diagnosis. The main advantages of integrating Machine Learning (ML) with microscopic and radiographic imaging is the ability to significantly reduce intra-and inter observer variability and improve diagnostic objectivity and reproducibility. Thirty Digitized slides were collected from different diagnostic centers of oral pathology in Brazil. After performing manual annotation in the region of interest, the images were segmented and fragmented into small patches. In the supervised learning methodology for image classification, three models (ResNet50, DenseNet, and VGG16) were focus of investigation to provide the probability of an image being classified as class0 (i.e., ameloblastoma) or class1 (i.e., Ameloblastic carcinoma). The training and validation metrics did not show convergence, characterizing overfitting. However, the test results were satisfactory, with an average for ResNet50 of 0.75, 0.71, 0.84, 0.65, and 0.77 for accuracy, precision, sensitivity, specificity, and F1-score, respectively. The models demonstrated a strong potential of learning, but lack of generalization ability. The models learn fast, reaching a training accuracy of 98%. The evaluation process showed instability in validation; however, acceptable performance in the testing process, which may be due to the small data set. This first investigation opens an opportunity for expanding collaboration to incorporate more complementary data; as well as, developing and evaluating new alternative models.

RECURRING AMELOBLASTOM INJURY IN THE ANTERIOR REGION OF JAW

An 86-year-old female patient complained of a lesion in the anterior region of the mandible with five previous surgical procedures and recurrences in all of them. Clinical examination revealed a hardened consistency, firm to palpation and normochromic color. Computed tomography showed a multilocular hypodense lesion with cortical bone destruction. The histopathological analysis showed a neoplastic lesion of odontogenic origin, characterized by the proliferation of epithelial cells grouped in a follicular pattern, and a peripheral palisade with nuclei exhibiting inverted polarity in the center of these enamel islands. The centers of these islands often show squamous metaplasia with the formation of keratin pearls, characterizing an acanthomatous pattern. The diagnosis of Ameloblastoma was established. The patient is awaiting surgical excision of the lesion. An 86-year-old female patient complained of a lesion in the anterior region of the mandible with five previous surgical procedures and recurrences in all of them. Clinical examination revealed a hardened consistency, firm to palpation and normochromic color. Computed tomography showed a multilocular hypodense lesion with cortical bone destruction. The histopathological analysis showed a neoplastic lesion of odontogenic origin, characterized by the proliferation of epithelial cells grouped in a follicular pattern, and a peripheral palisade with nuclei exhibiting inverted polarity in the center of these enamel islands. The centers of these islands often show squamous metaplasia with the formation of keratin pearls, characterizing an acanthomatous pattern. The diagnosis of Ameloblastoma was established. The patient is awaiting surgical excision of the lesion.

RESECTION OF AMELOBASTOMA AND IMMEDIATE RECONSTRUCTION WITH MICROVASCULARIZED FIBULAR GRAFT: A CASE REPORT

A 35-year-old female presented an intraoral swelling in the right posterior region of the mandible, which was asymptomatic, with two years of evolution. She presented an anatomopathological report with a previous diagnosis of ameloblastoma, but she was unable complete the proposed treatment due to the COVID-19 pandemic. Clinical examination revealed a granulomatous lesion in the right retromolar region, extending to the vestibular mucosa of elements 46 and 47, together with,bone expansion. A facial tomography showed an expansive, cystic, multilocular lesion, with erosion of the adjacent cortical bone in the right body, angle, and mandibular ramus, measuring approximately 4.6 × 2.2 × 3.7 cm. The patient underwent partial resection of the right posterior mandible with immediate reconstruction of a microvascularized fibular graft and fixation with a reconstruction plate. In the postoperative period, the patient evolved with satisfactory mandibular contour, good mouth opening, and preserved masticatory function. A 35-year-old female presented an intraoral swelling in the right posterior region of the mandible, which was asymptomatic, with two years of evolution. She presented an anatomopathological report with a previous diagnosis of ameloblastoma, but she was unable complete the proposed treatment due to the COVID-19 pandemic. Clinical examination revealed a granulomatous lesion in the right retromolar region, extending to the vestibular mucosa of elements 46 and 47, together with,bone expansion. A facial tomography showed an expansive, cystic, multilocular lesion, with erosion of the adjacent cortical bone in the right body, angle, and mandibular ramus, measuring approximately 4.6 × 2.2 × 3.7 cm. The patient underwent partial resection of the right posterior mandible with immediate reconstruction of a microvascularized fibular graft and fixation with a reconstruction plate. In the postoperative period, the patient evolved with satisfactory mandibular contour, good mouth opening, and preserved masticatory function.

Ameloblastoma of the Mandible With Carcinoma Transformation in a Young Adult.

Ameloblastic carcinoma (AC) is a rare and aggressive malignant epithelial odontogenic tumor making up less than 1% of malignant head and neck tumors. The majority of cases occur in the mandible with a minority occurring in the maxilla. Most occur de novo, while rare cases of AC have resulted from transformation from ameloblastoma. Here, we present a case in which a 30-year-old man presented with proptosis and a recurrent right temporal mass, which had been previously diagnosed as ameloblastoma on surgical pathology. CT findings demonstrated local invasion, and he was subsequently taken to the operating room for right craniotomy, infratemporal and middle cranial fossa tumor resection, and right modified radical neck dissection with reconstruction. Final pathology, which included areas of early focal necrosis, loss of peripheral palisading, and hyperchromatism, confirmed the diagnosis of ameloblastoma with transformation to AC. We further discuss radiologic and histopathological signs of this rare tumor, as well as recommended treatment modalities.

Application of Deep Learning in Differential Diagnosis of Ameloblastoma and Odontogenic Keratocyst Based on Panoramic Radiographs

Objective To evaluate the accuracy of different convolutional neural networks (CNN),representative deep learning models,in the differential diagnosis of ameloblastoma and odontogenic keratocyst,and subsequently compare the diagnosis results between models and oral radiologists. Methods A total of 1000 digital panoramic radiographs were retrospectively collected from the patients with ameloblastoma (500 radiographs) or odontogenic keratocyst (500 radiographs) in the Department of Oral and Maxillofacial Radiology,Peking University School of Stomatology.Eight CNN including ResNet (18,50,101),VGG (16,19),and EfficientNet (b1,b3,b5) were selected to distinguish ameloblastoma from odontogenic keratocyst.Transfer learning was employed to train 800 panoramic radiographs in the training set through 5-fold cross validation,and 200 panoramic radiographs in the test set were used for differential diagnosis.Chi square test was performed for comparing the performance among different CNN.Furthermore,7 oral radiologists (including 2 seniors and 5 juniors) made a diagnosis on the 200 panoramic radiographs in the test set,and the diagnosis results were compared between CNN and oral radiologists. Results The eight neural network models showed the diagnostic accuracy ranging from 82.50% to 87.50%,of which EfficientNet b1 had the highest accuracy of 87.50%.There was no significant difference in the diagnostic accuracy among the CNN models (P=0.998,P=0.905).The average diagnostic accuracy of oral radiologists was (70.30±5.48)%,and there was no statistical difference in the accuracy between senior and junior oral radiologists (P=0.883).The diagnostic accuracy of CNN models was higher than that of oral radiologists (P<0.001). Conclusion Deep learning CNN can realize accurate differential diagnosis between ameloblastoma and odontogenic keratocyst with panoramic radiographs,with higher diagnostic accuracy than oral radiologists.

A case of unicystic ameloblastoma of maxillary sinus: A rare case report

Ameloblastoma is a slowly growing, locally invasive tumor that primarily originates from enamel tissue and odontogenic epithelium. On the brain magnetic resonance imaging of a 34-year-old female patient, a 3cm-sized cystic mass was gound in the right maxillary sinus. A computed tomography of the paranasal sinuses with contrast enhancement showed irregular internal contrast enhancement occupying the space in the right maxillary sinus. A right endoscopic sinus surgery (ESS) showed a cystic mass and extensive tissue sampling was conducted. Histopathological examination confirmed the diagnosis of ameloblastoma. Concurrent chemoradiotherapy (CCRTx) was administered by oncology and radiation oncology departments. Three years follow up showed no recurrence.

Cytomorphological Characteristics Of Ameloblastoma By Fine Needle Aspiration Biopsy Procedure Confirmed With Histopathological Examination

Background: Ameloblastoma is the most common benign epithelial odontogenic tumor with malignant potential and is usually located in the jaw. It constitutes about 1-3% of all tumors and cysts of jaws. This entity has a very high recurrence rate of over 50% even after wide excision. Preoperative diagnosis of ameloblastoma can be made by fine-needle aspiration biopsy (FNAB) which is used as a guide for surgical planning. Case report: We report a case of a tumor in the mandible of a 41-year-old man with a preoperative diagnosis of ameloblastoma from a fine needle aspiration biopsy. Cytological examination of FNAB was confirmed by histopathological preparation of tumor tissue. Conclusion: The fine needle aspiration biopsy cytology is a reliable procedure for the pre-operative diagnosis of ameloblastoma. Pre-operative diagnosis of ameloblastoma can be used for planning therapy and early diagnosis of recurrence cases that can improve patient survival

MANDIBULAR RECONSTRUCTION USING MICROVASCULAR FIBULA FLAP: A CASE REPORT

Ameloblastoma is a benign, locally invasive odontogenic epithelial tumor, with aggressive behavior and a high rate of recurrence. Resection of these tumors invariably results in important bone defects that depend on surgical correction and planning for rehabilitation of the patient. The aim of this study is to present a clinical case of mandible ameloblastoma and discuss the aspects of the treatment. A 21-year-old female patient was referred for evaluation, presenting an extensive lesion in the left posterior region of the mandible. After clinical, imaging, and histopathologic examinations, the diagnosis of ameloblastoma was established. The tumor was treated by segmental resection, with wide margins and mandibular reconstruction using a microvascular fibula flap. No sign of recurrence was observed after 18 months of follow-up, and the mandibular function and facial aesthetics are satisfactory. We conclude that mandibular reconstructions are essential in the treatment of ameloblastomas.

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.

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.

AMELOBLASTOMA OF THE MAXILLARY SINUS: A CASE REPORT

A 64-year-old female patient presented with the chief complaint of pain in the right sinus region and history of previous traumatic extraction, but no swelling was observed. Imaging exams revealed a well-defined homogeneous expansive lesion, occupying the entire sinus and partially invading the right side of the nasal fossa, in addition to erosion of the alveolar process of the maxilla, resulting in buccosinusal communication. Incisional biopsy was performed, and the histopathologic diagnosis was ameloblastoma. The patient is currently under preoperative preparation for further definitive surgery. Ameloblastoma is an aggressive odontogenic tumor, with less than 20% of cases occurring in the maxilla, where the proximity to the orbit, skull base, and intracranial contents contributes to increase the morbidity rates of the tumor. In addition, due to its rarity in maxilla, the clinical diagnosis of ameloblastoma is challenging and commonly leads to a delay in proper management of the tumor. A 64-year-old female patient presented with the chief complaint of pain in the right sinus region and history of previous traumatic extraction, but no swelling was observed. Imaging exams revealed a well-defined homogeneous expansive lesion, occupying the entire sinus and partially invading the right side of the nasal fossa, in addition to erosion of the alveolar process of the maxilla, resulting in buccosinusal communication. Incisional biopsy was performed, and the histopathologic diagnosis was ameloblastoma. The patient is currently under preoperative preparation for further definitive surgery. Ameloblastoma is an aggressive odontogenic tumor, with less than 20% of cases occurring in the maxilla, where the proximity to the orbit, skull base, and intracranial contents contributes to increase the morbidity rates of the tumor. In addition, due to its rarity in maxilla, the clinical diagnosis of ameloblastoma is challenging and commonly leads to a delay in proper management of the tumor.

TREATMENT OF EXTENSIVE MULTICYSTIC AMELOBLASTOMA IN THE MANDIBLE WITH IMMEDIATE RECONSTRUCTION: CASE REPORT

Ameloblastoma is a benign odontogenic tumor of epithelial origin, locally aggressive, with an incidence of 0.5 cases per million. It is more common in the posterior region of the mandible, mainly during the third and fourth decades, with no sex preference. The World Health Organization classifies the tumor in different clinical variants and histologic patterns. A 34-year-old male patient presented a severe symphyseal swelling, with an undetermined evolution period. Tomographic findings revealed a mandibular hypodense, multilocular, poorly delimited image, with cortical destruction, measuring 95 mm in diameter. After the initial diagnosis of ameloblastoma, obtained through incisional biopsy, the lesion was completely resected with safe margins and the mandible was immediate reconstructed with a patient-specific titanium prosthesis. The histologic examination confirmed the previous diagnosis and the negative margins of the surgical specimen. The patient's recovery was uneventful, with no signs of recurrence and satisfactory mandibular function. Ameloblastoma is a benign odontogenic tumor of epithelial origin, locally aggressive, with an incidence of 0.5 cases per million. It is more common in the posterior region of the mandible, mainly during the third and fourth decades, with no sex preference. The World Health Organization classifies the tumor in different clinical variants and histologic patterns. A 34-year-old male patient presented a severe symphyseal swelling, with an undetermined evolution period. Tomographic findings revealed a mandibular hypodense, multilocular, poorly delimited image, with cortical destruction, measuring 95 mm in diameter. After the initial diagnosis of ameloblastoma, obtained through incisional biopsy, the lesion was completely resected with safe margins and the mandible was immediate reconstructed with a patient-specific titanium prosthesis. The histologic examination confirmed the previous diagnosis and the negative margins of the surgical specimen. The patient's recovery was uneventful, with no signs of recurrence and satisfactory mandibular function.