Both patients were treated by wide resection of the lesion with safety margins, and only one patient experienced tumor recurrence. Ameloblastoma is a benign odontogenic tumor of epithelial origin. Introduction of all swellings of the oral cavity, 9% are odontogenic tumours, and within this group, ameloblastoma accounts for 1% of lesions 14. Leave a comment on ameloblastoma histopathology pdf ameloblastoma is a rare, benign or cancerous tumor of odontogenic epithelium much more commonly appearing in the lower. There are six plexiform, two follicular, and one acanthomatous histological. Ameloblastomas frequently occur in relatively young people, but are rarely seen in people aged 80 years or older. In bw thesepresent stellate reticulumlike tissues less prominent compared to follicular ameloblastoma. Subsequently, the patient underwent incisional biopsy of the left mandibular mass confirming the diagnosis of plexiform ameloblastoma. Evaluation of mandibular odontogenic keratocyst and ameloblastoma by panoramic radiograph and computed tomography article pdf available in dentomaxillofacial radiology 477.
However, no enamel or hard tissue is formed by the tumor. Ameloblastoma is a benign but locally aggressive odontogenic tumor. Ameloblastomas are benign tumors derived from the odontogenic apparatus. Radical therapy is the recommended modality for solid ameloblastomas. Unicystic ameloblastoma, plexiform, intraluminal, tumor introducton ameloblastoma is a true neoplasm of odontogenic epithelium 1. Growth characteristics of ameloblastoma involving the. The plexiform type has epithelium that proliferates in a fish net pattern. Acanthomatous ameloblastoma cells occupying the position of the stellate reticulum undergo squamous metaplasia, sometimes with keratin formation in the centralcentral portion of the tumor islands. The ameloblast like cells are arranged in irregular masses, or more frequently, as a network of interconnected strands of cells. Ameloblastoma appears most commonly in the third to. Ameloblastoma is characterized by local aggressiveness and a high recurrence rate, with the predominant site of presentation is the mandible. In limited sample, may not be distinguishable from unicystic ameloblastoma macrocystic degeneration of conventional ameloblastoma limited biopsy sample requires inclusion of this entity in differential diagnosis basal palisading, with reverse polarity, hyperchromatic basal layer stellate reticulumlike layer. Follicular with plexiform ameloblastoma in anterior.
Majority occur in the mandible with about 520% occurring in the maxillary bone. Pdf on oct 26, 2018, akinshipo abdul warith and others published ameloblastoma. The tumor is often locally aggressive and has a significant impact and may have a patients morbidity and mortality. The trabeculae observed in our case continued to the peripheral cells of a small amount of epithelial sheets of plexiform ameloblastoma, and the tumor cells were positive for ck19, which is regarded as an immunohistochemical marker of odontogenic epithelium. The follicular ameloblastoma figure 4 e is further subdivided into acanthomatous, granular, spindle cell, and basal cell types. The principles of ameloblastoma resection are 1cm margins in bone and one layer of uninvolved soft tissue as a margin. Primary ameloblastoma of the sinonasal tract schafer. Solid multicystic ameloblastoma sma occur as growths arising from remnants of odontogenic epithelium, exclusively from rests of the dental lamina. Unicystic ameloblastoma with diverse mural proliferation a hybrid. Worldwide, maxillary ameloblastoma is rare, but its late detection renders adequate treatment difficult. Maxillary ameloblastoma extending into the maxillary sinus. Ameloblastoma is locally aggressive benign odontogenic tumour with increased risk of recurrence rate. We wish to share this case with the oral and maxillofacial fraternity and standardise the histopathology to aid in diagnosing these.
The estimation of annual incidence of ameloblastoma is 0. Pdf ameloblastoma is a benign odontogenic tumor of epithelial origin. Growth characteristics of ameloblastoma involving the inferior alveolar nerve. Pdf ameloblastoma of the acanthomatous and plexiform. It has an aggressive behavior and recurrent course, and is rarely metastatic. Unicystic plexiform ameloblastoma with mural proliferation. Unicystic ameloblastoma, plexiform ameloblastoma, enucleation case report a 14yearold boy was referred to the oral and maxillofacial surgery clinic with an asymptomatic swelling on his right cheek table fig1, which extended from the lower border of his mandible to the tragus of his ear and anteroposteriorly, from the corner of. There are layers of cells in between the proliferating epithelium with wellformed desmosomal junctions, simulating spindle cell layers. Plexiform ameloblastoma ameloblast like cells arranged in irregular masses. The choice of treatment depends on the histologic subtype.
Ameloblastoma is one of the most common odontogenic tumours with approximately making 11% of them. The peripheral ameloblastoma is the soft tissue version of the central intraosseous ameloblastoma. Thus, if the ameloblastoma is small and is within the alveolar process, this principle may be satisfied with a peripheral resection. Smas may also arise as a result of neoplastic changes in the lining or wall of a nonneoplastic odontogenic cyst, in particular dentigerous and odontogenic keratocysts. A wide spectrum of histological patterns have been described for ameloblastoma 11. The term plexiform unicystic ameloblastoma refers to a pattern of epithelial proliferation that has been described in cystic cavity.
Ameloblastomas are classified by the most predominant histologic pattern present 9. However, they may often behave clinically as biologically aggressive tumors. Pdf ameloblastoma is a benign locally invasive epithelial odontogenic tumour comprising 1% of all tumours and cysts arising in the jaws. Collision tumour, follicular ameloblastoma, haemangioma, odontogenic tumour, plexiform ameloblastoma dentistry section hemangiomatous ameloblastoma a case report of a very rare variant of ameloblastoma. Functional imaging combining petct is particularly use ful for diagnosing. Each of these strands is bound by a layer of tall columnar cells, between these layers may be found stellate reticulum like cells, these stellate reticulum like tissue is less prominent in. Ameloblastoma is a benign but locally aggressive tumor of epithelial origin that arises from enamel, dental follicle, periodontal ligaments or lining of odontogenic cysts 1, 2. Several histopathologic types of ameloblastoma are described and include plexiform, follicular, u n i cy s t i c, basal cell, granular cell, clear cell, a c a n t h o m a tous, vascular and desmoplastic patterns.
In this report, we present a case of a large ameloblastoma that presented with the typical radiographic features of variably sized radiolucent loculations. Ameloblastoma is the second most common odontogenic tumor, known to be. Its made from cells that form the enamel that protects your teeth the tumor can cause pain. The who defines it as a locallyinvasive polymorphic neoplasia that often has a follicular or plexiform pattern in a fibrous stroma. Ameloblastoma is a tumor originated from the epithelium involved with the formation of teeth. Establishing the natural history and growth rate of ameloblastoma. It was predominantly composed of epithelium arranged as a tangled network of anastomosing strands, enclosing cysts of various sizes, suggestive of plexiform ameloblastoma. Ameloblastoma represents 1% of all tumors and cysts that involve the maxillomandibular area and about 10% of the odontogenic tumors. Radiologically, it manifests itself in the form of uni or multicystic intrabony expansive lesions, with destruction of the medullary zone of the existing bone. The challenge in managing ameloblastoma is in achieving complete excision and reconstruction of the defect when the tumour is large. The case records and surgical biopsy reports of all diagnosed cases of ameloblastoma archived from january 2010 to december 2012 were retrieved from the outpatient department of oral medicine and radiology, vishnu dental college, bhimavaram, west godavari district.
Because of unilocular presentation, it is commonly misdiagnosed as an odontogenic cyst. A plexiform histologic pattern of ameloblastoma with back. Here we report a case of plexiform ameloblastoma of the left maxilla in a 30yearold male. Ameloblastoma ab is the second most common benign epithelial odontogenic tumor.
It is a rare head and neck tumor but it is still the most common odontogenic tumor. Here we present a case of plexiform ameloblastoma in a 30 year old female patient who presented with a swelling on the left side of mandible. These variations include follicular, plexiform, acanthomatous, granular cell, basal cell, unicystic, desmoplastic, and malignant types. The patient was a 82yearold man who noticed swelling of the gingiva approximately 2 weeks prior to his initial visit. In the present study, a case of unusually large plexiform ameloblastoma was presented with its clinical, radiological, histological features and treatment modalities, and this is the addition of one more case in the literature. B the columnar peripheral cells with reverse polarity of their nuclei is the most common and recognizable histologic feature of ameloblastoma. An intraoral biopsy was repeated under local anesthesia which confirmed the diagnosis of a plexiform ameloblastoma and the patient was scheduled. Similar to usual granular cell ameloblastoma, the tumor cells had cd68. Histologically ameloblastoma epithelium resembles that of the enamel organ of the developing tooth. Tumors of odontogenic origin may arise from the epithelial cells, the ectomesenchymal component, or a combination of both cell lines. Ameloblastoma is a rare kind of tumor that starts in your jaw, often near your wisdom teeth or molars. Ameloblastoma is a common and aggressive odontogenic epithelial tumor. The here presented retrospective analysis investigated the clinicoradiographic features of an overall of 115 dacases, having been reported in literature from 1984 to 2008. It is locally aggressive with unlimited growth capacity and has a high potential for malignant transformation as well as metastasis.
By combining data from all eligible published reports, we have derived at. The plexiform ameloblastoma shows epithelium proliferating in a cord like fashion, hence the name plexiform. The desmoplastic ameloblastoma da is characterized by specific clinical, imaging, and histological features. Clinical and radiologic behaviour of ameloblastoma in 4 cases. Functional imaging combining petct is particularly useful for diagnosing. Clinicopathological analysis of histological variants of. Molecular etiopathogenesis of ameloblastoma current. Follicular ameloblastoma was the most common histological type 50. Pdf evaluation of mandibular odontogenic keratocyst and. On occasion, epithelial or keratin pearls may even be observed. After 42 and 68 months of followup, the patients are still alive and. The ameloblastoma is a benign but aggressive neoplasm of odontogenic origin.
Different variants of unicystic ameloblastoma a report of. Ameloblastoma represents 1% of all tumors and cysts that involve maxillomandibular area and about 10% of odontogenic tumors. Ameloblastoma is an aggressive odontogenic tumor that forms from. The possibilities of recurrence even after enbloc resection are still high. Additionally, the predominance of plexiform ameloblastoma in the posterior maxilla is. Functional imaging combining petct is particularly use. Periapical ameloblastoma a case report british dental. Ameloblastoma arising from a dentigerous cysta case. The ameloblastoma, particularly the mixed cysticsolid type, is the most clinically significant odontogenic tumor. We present an uncommon variant of this entity, namely, unicystic ameloblastoma ua and describe its histopathological features as a fullblown lesion, such as its follicular, plexiform and mural forms. Of these tumors, 80% originate in the mandible, while 20% originate in the maxilla. The plexiform and follicular types are the most common patterns 8.
Six cases of maxillary ameloblastoma treated at the ucla hospitals are presented. Here we present a central jaw tumor in an 8yearold child which was a case of unusually large plexiform ameloblastoma involving entire ramus up to the condyle, and part of body of the mandible. This usually occurs in the follicular type of ameloblastoma. A clinical and histopathologic study author links open overlay panel norifumi nakamura dds, phd a takeshi mitsuyasu dds, phd b yoshinori higuchi dds, phd c ferry sandra dds d masamichi ohishi md, dds, phd e. Although radiotherapy can reduce the size of an ameloblastoma, primarily that part of the tumor which has expanded the jaw or broken into the soft tissues, it does not appear to be an appropriate. Ameloblastoma has no established preventive measures although majority of patients are between ages 30. Enhanced basal autophagy supports ameloblastomaderived. The author presents two case reports of recurrent ameloblastomas postradical resection.
It is primarily seen in adults in the third to fifth decade of life, with equal sex predilection. Computed tomography showed a radiolucent area with little. It has aggressive behavior and recurrent course, but it is rarely metastatic. A wide variety of odontogenic cysts and tumors may arise from these diverse cellular elements.
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