Ameloblastoma
🦷 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.
