Clinico-radiologic features of four cases of Ameloblastoma
Keywords:Radiograph. Universiti Sains Malaysia. Unicystic ameloblastoma. Jaws.
AbstractAmeloblastomas are jaw tumors that are locally aggressive with a high capacity for recurrence. It arises from the epithelium of the dental lamina. Radiograph remains the first and an essential investigation, despite the development of various cross-sectional imaging modalities. Aim: This article intends to describe the clinical findings and orthopantomograph (OPG) supported by computed tomography scan (CT scan) and MRI of four cases of ameloblastomas in the hospital University Sains Malaysia. Materials and methods: Data concerning the patients’ ages, sex, tumor locations, and surgical treatment history, as well as the radiographic findings, were analysed. Results: The patients’ ages ranged from 23 to 41 years (mean, 30.5 years). The gender of patients were two male (50%) and 2 (50%) females. Three cases (75%) of ameloblastomas located in the mandible and only one case found in the maxilla. The swelling was the most common symptom and experienced by all patients. Radiographically, two cases were unilocular with a well-demarcated border, and the remaining 2 cases were multilocular. Typical features of unicystic ameloblastoma appeared in case 1. This case previously presented with a lesion in the same area diagnosed as a dentigerous cyst. The other 3 cases showed variant types of ameloblastoma. These were Plexiform, Acanthomatous and Granular cell type; follicular and plexiform type; and follicular and plexiform type in case 2, 3 and 4 respectively. Conclusion: In conclusions, determination the location and density of jaws lesion and its margin relation to the tooth using radiological tool accompanied with clinical data, aids in the narrowing of the differential diagnosis and it is necessary for early diagnosis of ameloblastoma. A Long-term follow-up at regular intervals after surgery is recommended for all ameloblastomas cases.
Becelli R, Carboni A, Cerulli G, Perugini M, Iannetti G. Mandibular ameloblastoma: analysis of surgical treatment carried out in 60 patients between 1977 and 1998. J Craniofac Surg. 2002 May;13(3):395-400; discussion 400.
Iordanidis S, Makos C, Dimitrakopoulos J, Kariki H. Ameloblastoma of the maxilla — case report. Aust Dent J. 1999 Mar;44(1):51-5.
Nakamura N, Mitsuyasu T, Higuchi Y, Sandra F, Ohishi M. Growth characteristics of ameloblastoma involving the inferior alveolar nerve: a clinical and histopathologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 May;91(5):557-62.
Hollows P, Fasanmade A, Hayter JP. Ameloblastoma – a diagnostic problem. Br Dent J. 2000 Mar 11;188(5):243-4.
Sirichitra V, Dhiravarangkura P. Intrabony ameloblastoma of the jaws. An anaylsis of 147 Thai patients. Int J Oral Surg. 1984 Jun;13(3):187-93.
Tan W T L, The L Y, Ho K H, Lee ST. Mandibular ameloblastoma in Singapore - A 10 year review. Ann Acad Med Singapore. 1986 Jul;15(3):378-83.
Kameyama Y, Takehana S, Mizohata M, Nonobe K, Hara M, Kawai T, et al. Aclonicopathological study of ameloblastomas. Int J Oral Maxillofac Surg. 1987 Dec;16(6):706-12.
Cawson RA, Odell EW. Cawson’s essentials of oral pathology and oral medicine. 7th ed. Churchill Livingstone; 2002. Chapter 17: Oral cancer.
Yaacob H. The radiographic appearance of ameloblastoma in Malaysians. Singapore Med J. 1991 Feb;32(1):70-2.
Ng KH, Siar C H, Chuah C H. Ameloblastoma in Malaysian children. Asian J Oral Maxillofac Surg.1989;1:57-62.
Ng KH, Siar C H. Peripheral ameloblastoma with clear cell differentiation. Oral Surg Oral Med Oral Pathol. 1990 Aug;70(2):210-3.
Siar CH, Ng KH. Ameloblastoma in Malaysia-25 years review. Ann Acad Med Singapore. 1993 Nov;22(6):856-60.
Reichart PA, Philipsen HP, Sonner S. Ameloblastoma: Biological Profile of 3677 Cases. Oral Oncology, Eur J Cancer B Oral Oncol. 1995 Mar;31B(2):86-99.
Lucas RB. Pathology of tumours of the oral tissues. 4th ed. Edinburgh: Churchill Livingstone; 1984. p.31-59.
Brazis PW, Miller NR, Lee AG, Holliday MJ. Neuro-ophthalmologic aspects of ameloblastoma. Skull Base Surg. 1995;5(4):233-44.
Jordan RCK, Speight PM. Current concepts of odontogenic tumours. Diagn Histopathol. 2009;15(6):303-10.
William TP. Management of ameloblastoma: A changing perspective. J Oral Maxillofac Surg. 1993 Oct;51(10):1064-70.
Gardner DG. Controversies in the nomenclature, diagnosis and treatment of ameloblastoma. In: Worthington P, Evans JR, editors. Controversies in oral and maxillofac surgery. Philadelphia, PA: Saunders; 1994. p.362.
Gardner DG, Pecak AM. The treatment of ameloblastoma based on pathologic and anatomic principle. Cancer. 1980 Dec 1;46(11):2514-9.
Collings SJ, Harrison A. Recurrent Ameloblastoma? An historic case report and a review of literature. Br Dent J. 1993 Mar 20;174(6):202-6.
Torres-Lagares D, Infante-Cossío P, Hernández-Guisado JM, Gutiérrez-Pérez JL. Mandibular ameloblastoma. A review of the literature and presentation of six cases. Med Oral Patol Oral Cir Bucal. 2005 May-Jul;10(3):231-8.
Hollows P, Fasanmade A, Hayter JP. Ameloblastoma -- a diagnostic problem. Br Dent J. 2000 Mar 11;188(5):243-4.
Ogunsalu C, Daisley H, Henry K, Bedayse S, White K, Jagdeo B, et al. A new radiological classification for ameloblastoma based on analysis of 19 cases. West Indian Med J. 2006 Dec;55(6):434-9.
Tozaki M, Hayashi K, Fukuda K. Dynamic multislice helical CT of maxillomandibular lesions: distinction of ameloblastomas from other cystic lesions. Radiat Med. 2001 Sep-Oct;19(5):225-30.
Artés-Martínez MJ, Prieto-Rodríguez M, Navarro-Hervás M, Peñas-Pardo L, Camañas-Sanz A, Vaquero de la Hermosa MC, et al. Ameloblastoma. Diagnosis by means of FNAB. Report of two cases. Med Oral Patol Oral Cir Bucal. 2005 May-Jul;10(3):205-9.
Small IA, Waldron CA. Ameloblastoma of the jaws. Oral Surg Oral Med Oral Pathol. 1955 Mar;8(3):281-97.
Small IA. Recurrent ameloblastoma, 25 years after hemimandibulectomy. Oral Surg Oral Med Oral Pathol. 1956 Jul;9(7):699-706.
Adekeye EO. Ameloblastoma of the jaws: a survey of 109 Nigerian patients. J Oral Surg. 1980 Jan;38(1):36-41.
Gardner AF, Apter MB, Axelrod JH. A study of twenty-one instances of ameloblastoma, a tumor of odontogenic origin. J Oral Surg Anesth Hosp Dent Serv. 1963 May;21:230-7.
Ito S, Mandai T, Ishida K, Kitamura N, Deguchi H, Hata T, et al. Unicystic ameloblastoma of the maxilla : A case report. Kawasaki Med J. 2009;35(1):95-8.
Konouchi H, Asaumi J, Yanagi Y, Hisatomi M, Kawai N, Matsuzaki H, et al. Usefulness of contrast enhanced-MRI in the diagnosis of unicystic ameloblastoma. Oral Oncol. 2006 May;42(5):481-6.
Rampton P. Teeth and jaws. In: Sutton D, editor. Textbook of radiology and imaging. Philadelphia: Churchill-Livingstone; 1998. p.1388-9.
Gümgüm S, Hoşgören (2005). Clinical and radiologic behaviour of ameloblastoma in 4 cases. J Can Dent Assoc. 2005 Jul-Aug;71(7):481-4.
Cihangiroglu M, Akfirat M, Yildirim H. CT and MRI findings of ameloblastoma in two cases. Neuroradiology. 2002 May;44(5):434-7.
Moe H, Clausen F, Philipsen HP. The ultrastructure of the simple ameloblastoma. Acta Pathol Microbiol Scand. 1961;52:140-54.
Shatkin S, Hoffmeister FS. Ameloblastoma: a rational approach to therapy. Oral Surg Oral Med Oral Pathol. 1965 Oct;20(4):421-35.
Ueno S, Mushimoto K, Shirasu R. Prognostic evaluation of ameloblastoma based on histologic and radiographic typing. J Oral Maxillofac Surg. 1989 Jan;47(1):11-5.
Shafer WG, Hine MF, Levy BM. A Textbook of Oral Pathology. 4th ed. Saunders; 1983. Chapter 4: Cysts and Tumours of Odontogenic Origin.
El-Sissy NA. Immunohistochemical detection of p53 protein in ameloblastomas types. East Mediterr Health J. 1999 May;5(3):478-89.
Vered M, Shohat I, Buchner A. Epidermal growth factor receptor expression in ameloblastoma. Oral Oncol. 2003 Feb;39(2):138-43.
Vogelstein B, Kinzler KW. The genetic basis of human cancer. 2nd ed. New York: McGraw Hill; 2002. Chapter 23: Syndrome by David Malkin. p.387-401.
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