Makindo Medical Notes

🦷 Ameloblastoma is a rare, benign but locally aggressive odontogenic tumour arising from the enamel-forming epithelium. Most commonly in the mandible, it can cause significant jaw expansion and deformity if untreated.

📖 About

• Incidence: ~1% of all jaw tumours/cysts.
• Age Group: Peak 30–50 years (but any age possible).
• Location: Mandible (esp. molar & ramus region) >> Maxilla.
• Histopathology: From dental lamina, enamel organ, or odontogenic cyst lining.

🧬 Etiology

• Exact cause uncertain, but linked with:
  • Genetic mutations → esp. BRAF V600E.
  • Chronic irritation/inflammation.
  • Association with impacted teeth/odontogenic cysts.

🩺 Clinical Presentation

• Often asymptomatic in early stages → incidental finding.
• Painless jaw swelling or bony expansion.
• Facial asymmetry & displacement of teeth.
• Root resorption (seen radiographically).
• Occasional pain or paraesthesia if nerves compressed.

🩻 Radiographic Features

• Classic multilocular radiolucency → “soap bubble” or “honeycomb” appearance 💡.
• Well-defined lesion with cortical thinning & expansion.
• Root resorption of adjacent teeth.

🔬 Histological Subtypes

• Conventional (Solid/Multicystic): Most common, aggressive, higher recurrence.
• Unicystic: Single cyst-like lesion, less aggressive, younger patients.
• Peripheral: In soft tissue overlying bone, rare.
• Desmoplastic: Dense stroma with collagenisation.

🛠️ Management

• Surgery = gold standard
  • Radical resection (marginal/segmental mandibulectomy) → lower recurrence.
  • Curettage/enucleation → higher recurrence, sometimes used for small lesions.
• Reconstruction: May require bone grafts, flaps, or prosthetics for function/appearance.
• Follow-up: Lifelong surveillance → recurrences can appear years later.

📊 Prognosis

• Benign but locally invasive.
• Recurrence:
  • 5–15% after wide resection.
  • >50% after curettage alone.
• Rare malignant transformation → ameloblastic carcinoma.

📚 References

• Philipsen HP, Reichart PA. J Oral Pathol Med. 2006.
• Speight PM, Takata T. Virchows Arch. 2017.