Search

Ameloblastomas are quite frequent odontogenic tumors, they can be intraosseous or peripheral to the gum, it's rare to find an intraosseous ameloblastoma with gingival extension. Here, we report the case of a 40 years old woman who presented with an exophytic gingival lesion at the gum level of the 46 tooth that was extracted at a quack 01 years before her consultation due to pain in this area. Clinical and radiological examination revealed the presence of two tumors in the same area. The patient benefited from an excision of her gingival tumor and an enucleation of her intraosseous tumor. Histopathological and immunohistochemical examinations revealed that the respective tumors were a spindle cell epulis and an intraluminal unicystic ameloblastoma of different origins, leaving the question and search for the relationship between these two tumors. The postoperative course was uneventful during the 12-month follow-up period after surgical treatment., Highlights • Ameloblastoma is a fairly rare tumor that can be intraosseous or peripheral. • It is rare to find a peripheral ameloblastoma that reaches the bone or an intraosseous ameloblastoma that extends to the gum. • The occurrence of two tumors in the same anatomical region, makes one wonder about the relationship between the two.

ObjectiveThis study aimed to systematically investigate and compare the post-treatment recurrence of intraosseous ameloblastoma in patients treated with conservative or aggressive approaches.MethodsSystemic searches of PubMed, Medline, Cochrane Library, and Embase databases from inception to October 28, 2020, were conducted. Studies that aimed to evaluate the recurrence of intraosseous ameloblastoma by conservative and aggressive treatment approaches were included.ResultsA total of 20 studies with 942 ameloblastoma cases were included. Fourteen studies included patients with ameloblastoma who received conservative treatment, and 16 studies reported the overall recurrence rate for patients undergoing aggressive treatment. The pooled results indicated that the recurrence rate for aggressive treatment [0.12, 95% confidence interval (CI) = 0.09–0.16] was significantly lower than that for conservative treatment, with a recurrence rate of 0.30 (95% CI = 0.23–0.39). Similar results were obtained when stratifying the participants by the histological classification. When trying stratification analysis following the original included studies, multicystic ameloblastoma presented a much higher recurrence rate than solid and unicystic ameloblastomas.ConclusionThese findings supported the hypothesis that aggressive treatment might lead to a lower recurrence rate than conservative treatment. More studies and meta-analyses following the new histological classification of ameloblastomas are needed to validate and support the findings.

Peripheral ameloblastoma, a soft-tissue analogue of intraosseous ameloblastoma, is a rare odontogenic tumor with histologic characteristics of ameloblastoma. In contrast to conventional ameloblastoma, peripheral ameloblastomas are considered as innocuous lesions which usually do not show invasion of the underlying structures. Rarely, intraosseous ameloblastoma which penetrates the alveolar bone can fuse with the overlying oral epithelium and eventually manifest as an exophytic peripheral lesion. Such lesions which mimic peripheral ameloblastoma both clinically and microscopically are termed as peripheral intraosseous ameloblastoma. As per the existing criteria, soft-tissue ameloblastomas showing bone invasion are strictly excluded from the category of peripheral ameloblastoma and are considered as peripheral intraosseous ameloblastoma. We report a rare case of extraosseous ameloblastoma with clear origin from the superficial epithelium showing the presence of a few odontogenic islands in the underlying bone suggestive of a neoplastic osseous invasion. This paper discusses the diagnostic challenges associated with peripherally occurring ameloblastomas and stresses the need for accurate diagnosis in deciding the treatment modalities.

Ameloblastoma is an odontogenic tumor of high frequency and usually occurs as an intraosseous growth. Ameloblastomas frequently recur, sometimes undergoing malignant transformation. These tumors are usually characterized as being multilocular, of the follicular type histopathologically, and invading strongly at the border region of the tumor. More than 10% p53-positive tumor cells give a prognostic indication for a tendency to recur. A recurrent ameloblastoma usually occurs in the intraosseous region near the site of the original lesion. In very rare cases, a recurrent tumor proliferates distantly from the original site in the soft tissue only. We report a rare case of recurrent ameloblastoma in the buccal mucosa with a mucocele that originated from the small salivary glands after the extirpation of an intraosseous (mandibular) ameloblastoma. We also performed a p53 immunohistochemical study of this recurrent tumor.

Introduction Ameloblastoma is a rare, benign, purely epithelial odontogenic tumour, characterized by a high potential for local invasion and recurrence. Objective To study the epidemiological and histological characteristics of ameloblastoma. To study Ki67 and CD10 immunostaining in ameloblastoma and to investigate a possible correlation between these two markers and recurrence of this tumour. Methods An immunohistochemical study using Ki67 and CD10 monoclonal antibodies was performed on 37 paraffin blocks obtained from the Charles-Nicolle hospital pathology department in Tunis over a 9-year period (2004–2012). Statistical analysis was performed with Statistical Package for Social Sciences (SPSS) software version 15.1. Results This series of 37 cases comprised 21 males and 16 females (sex ratio: 1.3) with a mean age of 39 years (range: 7 to 70 years), corresponding to 36 cases of intraosseous ameloblastoma and one case of gingival ameloblastoma. Thirty-two cases were polycystic and 5 cases were unicystic. Eighteen cases of local recurrence were observed. No correlation was demonstrated between recurrence and the various clinical and histological parameters and treatment modalities. However, a significant correlation was demonstrated between recurrence and Ki67 and CD10 expression (P = 0.000 and 0.002, respectively). Conclusion The Ki67 proliferation index and stromal CD10 expression can be considered to be predictive factors of ameloblastoma recurrence.

Ameloblastoma is a slow-growing but locally invasive odontogenic tumor, with a high rate of recurrence if not removed adequately. Most commonly it is located intraosseously in both jaws, and there are few or no clinical signs in the early stages. It seldom presents as a soft tissue growth, but when it does it becomes tricky for the general dentist to diagnose the tumor and endow with appropriate treatment. It is of importance to understand that the local biologic behavior of an intraosseous ameloblastoma is that of a low grade malignant tumor. This article describes a case of ameloblastoma involving a 50-year-old female, which had unusual presentation as exophytic growth, without expansion of the cortex and showing diverse histological patterns.

Our aim was to evaluate the treatment given to patients with intraosseus ameloblastomas with special emphasis on recurrence and the outcomes of primary and secondary resection. Forty-eight patients who were treated for intraosseous ameloblastoma at 8 centres across Sweden met the inclusion criteria. They showed typical distribution of age, sex, site of lesion, and characteristic presenting features. Eleven of the 48 were initially treated with radical resection and none recurred. Twenty-two of the remaining 37 who were initially treated by conservative resection presented with recurrences. Sixteen of the 22 then had conservative secondary resections, which resulted in further recurrence in 6 patients. Initial radical resection is therefore superior to conservative management as far as recurrences are concerned. We argue, however, that a conservative surgical approach is adequate for many intraosseous ameloblastomas with limited extension, because relapse can be followed by radical resection if clinically indicated in selected cases.

Peripheral ameloblastoma (PA) is a rare and unusual entity with histological characteristics similar to those of the common intraosseous ameloblastoma. In this paper, we present a case of PA in a 44-year-old male affecting the right retromolar trigone area along with its immunohistochemical profile using CK19 and Ber-EP4 markers.

Objectives: To provide epidemiological data of ameloblastomas of the jaws in the Netherlands over a 25-year time period (1985-2010) and to compare these data with data from other parts of the world. Material and Methods: The data of all patients diagnosed with a primary ameloblastoma of the jaws in the Netherlands in the period 1985-2010 have been retrieved from the nationwide histopathology and cytopathology network and registry in the Netherlands (PALGA). The pathology reports were screened and only those cases were included in which a distinct diagnosis of primary, histopathologically benign, intraosseous ameloblastoma was rendered. The average population in The Netherlands during this period amounted approximately 15 million people. Results: An annual incidence rate was approximately 1,5 per million population, the male-female ratio being 1.4: 1. The age at the time of diagnosis was 44.1 years. The average age in males was 46.3 years compared to an average age in females of 41.3 years, the difference being significant (p≤ 0.05). The results were compared with those available in only a small number of publications worldwide. Conclusions: There is no strong evidence for significant differences of the true incidence of ameloblastomas worldwide, neither for a gender predilection. The diagnosis is generally made at a somewhat lower age in women; this phenomenon is even much stronger in the Black population, irrespective of gender. No proper explanation for this finding can be provided. Key words:Odontogenic tumor, ameloblastoma, epidemiology.

Peripheral ameloblastoma (PA) is a rare, extraosseous odontogenic tumor with histologic features similar to those of the more common intraosseous ameloblastoma. The exact nature and tumorigenesis of PA are unclear. Although there are some reports on the cytogenetics of intraosseous ameloblastoma, to the authors' knowledge, there are no studies on the cytogenetic analysis of PA. The cytogenetic analysis of a PA occurring in the gingiva of a 56-year-old man is presented. Trisomy 7 was the only cytogenetic aberration.

The aim of the present study is to examine all cases of intraosseous benign ameloblastomas treated between 1970 and 2010 in a single institution and to look for a possible correlation between the histopathological aspects and the demographical and clinical parameters, as well as the treatment outcome. The data of a total number of 44 patients were retrieved from the records. Nine patients were excluded because of doubt about the correct diagnosis (8 patients) or because of an extra-osseous presentation (1 patient). No statistically significant differences were found between the histopathological (sub)types of ameloblastomas and the demographical and clinical parameters, nor between the histopathological (sub)types and treatment outcome. Of the 28 patients treated by enucleation, in 17 patients one or more recurrences occurred, with no significant predilection for any histopathological (sub)type, including the unicystic type. There were no significant differences in the recurrence rate after enucleation in patients below and above the age of 20 years either. In six out of 17 patients with a recurrence, the recurrent lesion showed a different histopathological subtype than was encountered in the primary. In two cases a change from solid/multicystic to desmoplastic ameloblastomas was noticed. In conclusion, the current histopathological classification of benign intraosseous ameloblastoma does not seem to have clinical relevance with the possible exception of the luminal unicystic ameloblastoma that has been removed in toto, unfragmented. Since no primary desmoplastic ameloblastomas were encountered in the present study no further comments can be made on this apparently rare entity. Key words: Odontogenic tumours, ameloblastoma, histopathology.

This paper reviews the types of surgical and nonsurgical treatment modalities that have been used to treat the classic intraosseous ameloblastoma of the jaws. The clinical, anatomic and biologic factors that may influence the clinicians' selection of a particular treatment modality were highlighted. Surgeons should be aware of these different modalities if they are to formulate a surgical treatment plan that is individualised to fit different clinical situations.

Peripheral ameloblastoma is a rare, benign odontogenic tumor that histologically resembles an intraosseous ameloblastoma but develops in the soft tissues of the gingiva and mucosa and exhibits an innocuous clinical behavior. We report a case of a recurrent peripheral ameloblastoma in a 61-year-old man that presented as a painless swelling on the maxillary anterior labial attached gingiva. Clinical and histopathologic features of this lesion are discussed. The peripheral ameloblastoma should be included in the differential diagnosis of a gingival lesion clinically resembling any of the myriads of entities seen on the gingiva including a pyogenic granuloma, peripheral giant cell granuloma, or parulis/gumboil. We believe this case highlights the need for submitting excised tissue for microscopic examination.

This article describes some fundamental concepts and new developments in the pathologic characteristics of ameloblastoma. The former include (1) the necessity of separating ameloblastomas into three clinical types, namely the solid or multicystic (the classic intraosseous ameloblastoma), the unicystic, and peripheral varieties; (2) the importance of the tumor's location in the jaws; and (3) the manner in which cancellous and compact bone of the jaws affect the spread of ameloblastomas. New developments discussed include the desmoplastic ameloblastoma, the clear cell ameloblastoma, the recognition of the so-called acanthomatous epulis in dogs as a fairly common spontaneous animal model of ameloblastoma, and some work concerning therapeutic irradiation of ameloblastomas. Additional topics include the problems involved in the early microscopic diagnosis of ameloblastoma and of ameloblastic carcinoma and our lack of knowledge concerning the cause of ameloblastomas.

Intraosseous ameloblastoma is the most common and simple type of ameloblastoma prevalent among odontogenic tumors. Clinico-radiographically intraosseous ameloblastoma presents as slow, painless swelling or expansion of the jaws and described as multilocular expansile radiolucency that occurs most frequently in mandibular molar/ramus area. This article describes a case of follicular ameloblastoma involving 45 year old male which is different from the usual presentation, which includes-exophytic growth, different location and without expansion of the cortex.

A new case of the rare peripheral ameloblastoma of the gingiva is presented. Also the clinical and histomorphologic characteristics of the lesion were analyzed and studied in all previously documented cases. This tumor, and the basal cell carcinoma of the gingiva, probably represent the same lesion. It meets the same microscopic criteria as the intraosseous ameloblastoma, but its behavioral and clinical characteristics are completely different. The peripheral ameloblastoma usually occurs in the gingiva, is noninvasive, and local excision is usually curative. Recurrence of the neoplasm is uncommon, except when it is incompletely excised. The histogenesis and varied cellular pattern of the peripheral ameloblastoma and several other related odontogenic lesions of the gingiva illustrate the proliferative and differentiation potential of the basal cell layer of gingival epithelium.