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Inthong P, Upalananda W, Saepoo J. Factors Associated with Recurrence of Ameloblastoma: A Scoping Review. Head Neck Pathol 2024; 18:82. [PMID: 39177897 PMCID: PMC11343934 DOI: 10.1007/s12105-024-01686-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 08/07/2024] [Indexed: 08/24/2024]
Abstract
PURPOSE This scoping review aimed to identify factors associated with the recurrence of ameloblastoma. METHODS Systematic searches were conducted in PubMed, Scopus, and EMBASE, based on the board research question: "What factors are related to the recurrence of ameloblastoma?". English-language observational studies addressing the risk and preventive factors associated with recurrent ameloblastoma were included and data were extracted. RESULTS Eighty-three retrospective observational studies met the inclusion criteria. The identified prognostic factors for recurrence included: (1) Tumor size/diameter/volume, (2) cortical bone perforation/ soft tissue invasion, (3) multilocular radiolucency, (4) impacted tooth-involving lesions, (5) root resorption, (6) WHO classification - conventional (solid/multicystic) ameloblastoma, (7) histological subtype - mural invasion of unicystic ameloblastoma, (8) conservative treatment modalities - simple enucleation, curettage, and marsupialization, and (9) non-extraction/preservation of involved teeth. No strong evidence linked immunohistochemical expression to recurrence. Interestingly, BRAF p.V600E remained controversial in terms of recurrence, despite being a frequent finding in ameloblastoma. CONCLUSION Certain clinical characteristics, radiographic findings, histological subtypes, and treatment choices of ameloblastoma can help identify patients at high risk of recurrence. Further prospective studies to evaluate the prognostic factor model and research on immunohistochemistry are required.
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Affiliation(s)
- Pornnutcha Inthong
- Section of Oral and Maxillofacial Pathology, Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Witsarut Upalananda
- Section of Oral and Maxillofacial Radiology, Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Jay Saepoo
- Section of Oral and Maxillofacial Pathology, Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand.
- Section of Oral Medicine, Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand.
- , Kanjanavanich Rd., Hatyai, Songkhla, 90110, Thailand.
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Yang R, Lin X, Zhang W, Gokavarapu S, Lin C, Ren Z, Hu Y, Cao W, Ji T. Unicystic ameloblastoma: A retrospective study on recurrent factors from a single institute database. Oral Dis 2024; 30:1475-1482. [PMID: 36564985 DOI: 10.1111/odi.14477] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 12/01/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Unicystic ameloblastomas are a variant of ameloblastoma with a definite recurrence rate because of the biological behaviours of the tumour. The risk factors associated with disease recurrence were analysed in this retrospective study. METHODS A total of 132 patients with primary unicystic ameloblastoma reported in a tertiary hospital from 2005 to 2015 were analysed to identify the clinic-pathological and radiological factors associated with recurrence using univariate and multivariate Cox regression analyses. RESULTS The mean volume was 30.54cm3 ± 12.55 cm3, and this value differed significantly according to recurrence (p < 0.001). Root resorption and bone cortex/soft tissue invasion were also significantly associated with recurrence among unicystic ameloblastoma patients (p = 0.017 vs. p < 0.001, respectively). A new stage classification system was developed to predict disease recurrence of patients. The multivariate Cox regression analysis revealed that the new stage classification system was the only predictor of disease recurrence in unicystic ameloblastoma patients (p < 0.001), regardless of root resorption, position and site characteristics. CONCLUSIONS Volume, root resorption and bone cortex/soft tissue invasion were risk factors for disease recurrence among unicystic ameloblastoma patients. The new stage classification was an independent predictor of disease recurrence in patients with unicystic ameloblastoma.
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Affiliation(s)
- Rong Yang
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xiaohu Lin
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Wenming Zhang
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Sandhya Gokavarapu
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Chengzhong Lin
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Zhenhu Ren
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yongjie Hu
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Wei Cao
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Tong Ji
- Department of Oral and Maxillofacial - Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
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3
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de Farias Morais HG, Gonçalo RIC, de Oliveira Costa CS, de Figueiredo Pires H, Mafra RP, de Morais EF, da Costa Miguel MC, de Almeida Freitas R. A Systematic Review of Adenoid Ameloblastoma: A Newly Recognized Entity. Head Neck Pathol 2023; 17:688-696. [PMID: 37540485 PMCID: PMC10513974 DOI: 10.1007/s12105-023-01574-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/07/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Recently, a new odontogenic tumor has been described, the so-called adenoid ameloblastoma (AdAM). The aim of this review was to determine the clinical and imaging features of AdAM and to describe its main histopathological findings. METHODS The systematic review included published cases with a diagnosis of AdAM in the gnathic bones, which had sufficient clinical, imaging, and histopathological data to confirm its diagnosis. The following histopathological diagnostic criteria were adopted: presence of ameloblastoma-like components, duct-like structures, spiral cellular condensations, and a cribriform architecture. RESULTS Fifteen articles, corresponding to 30 cases of AdAM, were selected. Most cases affected men (63.3%), with a slight preference for the mandible (16:14) and the posterior region of gnathic bones was the most commonly affected site. The mean age at diagnosis was 40.8 years. Clinically, the lesions usually presented as a swelling (53.3%) and, radiographically, as a well-defined radiolucency (33.4%). Surgical resection (40%) was the most frequently adopted treatment and recurrence occurred in 30% of cases. Microscopic examination showed cribriform areas in most AdAM cases (93.3%); duct-like structures and spiral cellular condensations were seen in 100% of the cases. CONCLUSION The small number of reported cases, the existence of erroneous diagnoses, and the adoption of initial conservative management make it difficult to determine whether AdAM has a higher risk of recurrence or more aggressive biological behavior than conventional ameloblastomas.
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Affiliation(s)
- Hannah Gil de Farias Morais
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN CEP 59056-000 Brazil
| | - Rani Iani Costa Gonçalo
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN CEP 59056-000 Brazil
| | - Carla Samily de Oliveira Costa
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN CEP 59056-000 Brazil
| | - Hévila de Figueiredo Pires
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN CEP 59056-000 Brazil
| | - Rodrigo Porpino Mafra
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN CEP 59056-000 Brazil
| | | | - Márcia Cristina da Costa Miguel
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN CEP 59056-000 Brazil
| | - Roseana de Almeida Freitas
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN CEP 59056-000 Brazil
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Anyanechi CE, Shetty SS. Ameloblastoma of the jaws in adult: A retrospective review of local recurrent lesions based on the resection margin in the adjacent apparent healthy tissues. Heliyon 2023; 9:e16243. [PMID: 37251853 PMCID: PMC10209404 DOI: 10.1016/j.heliyon.2023.e16243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 04/26/2023] [Accepted: 05/10/2023] [Indexed: 05/31/2023] Open
Abstract
Background The surgical treatment of ameloblastoma of the jaws remains contentious due to the variable recurrence rate amongst its variants, the tumor's local invasive behavior, and the lack of consensus among surgeons concerning the extent of resection in the contiguous healthy tissues. Objective To determine the recurrence rate of ameloblastoma and its association with the resection margins. Materials and methods This is a retrospective cohort study of the medical records of patients who underwent surgical resection of the jaws as the primary modality of treatment for ameloblastoma. Clinical data over the 26 years were analyzed for age, gender, site of the lesion, size, radiographic appearance, histopathological sub-type, and the incidence of recurrence post-treatment. Descriptive and bivariate statistics were computed. Results A retrospective audit of 234 cases was included in the study that was typical (solid/multicystic) ameloblastoma. The age of patients ranged from 20 to 66 years with a mean age of 33.4 ± 9.6 years, and a male-to-female ratio of 1.2: 1 (P = 0.52). The follicular and plexiform types accounted for the majority of histopathological variants (89.8%; P = 0.000). Overall, 6.8% of cases relapsed after the initial primary surgery. The rate of recurrence was high with a resection margin of 1.0 or 1.5 cm than 2.0 cm (P = 0.001). No case of recurrence was seen with a resection margin of 2.5 cm margin. Conclusion A low recurrence rate of 6.8% was noted in our series of cases. A wide 2.5 cm resection margin is recommended in the adjacent healthy tissues.
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Affiliation(s)
- Charles Ezechukwu Anyanechi
- Department of Oral and Maxillofacial Surgery, University of Calabar/University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Sameep S. Shetty
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, 575001, India
- Manipal Academy of Higher Education, a Constituent of MAHE, Manipal, India
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Sozzi D, Cassoni A, De Ponti E, Moretti M, Pucci R, Spadoni D, Canzi G, Novelli G, Valentini V. Effectiveness of Resective Surgery in Complex Ameloblastoma of the Jaws: A Retrospective Multicenter Observational Study. Cancers (Basel) 2022; 14:cancers14194608. [PMID: 36230531 PMCID: PMC9559477 DOI: 10.3390/cancers14194608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Ameloblastoma is a rare, benign, odontogenic tumor of epithelial origin, characterized by locally aggressive, expansive growth. Treatment is controversial due to the risk of relapse. The aim of this multicenter retrospective study was to evaluate the effectiveness of complete resection in cases of complex ameloblastoma, which is considered at a higher risk of recurrence. Patients who met at least one of these criteria were included: recurrence, soft-tissue involvement, complete erosion of internal/external cortical walls with involvement of the inferior margin of the mandible, and invasion of the maxillary sinus or nasal cavity. Demographic data, tumor site, type of surgery, histological features, and follow-up information were collected for each patient. The cohort included 55 patients with a mean follow-up of 108 ± 66 months. A multivariate logistic model was used to evaluate variables independently associated with relapse. There were six soft-tissue or maxillary sinus relapses, with a recurrence rate of 10.9%. Most of them arose in patients previously treated. The statistical analysis identified the maxillary location as a fundamental relapse risk factor. En bloc resection with large surgical safety margins seemed to be effective in preventing the relapses. However, complete resection was less effective in preventing recurrences in the soft tissues or maxillary sinus.
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Affiliation(s)
- Davide Sozzi
- Maxillofacial Surgery Unit, ASST Monza—San Gerardo Hospital, 20900 Monza, Italy
- Department of Medicine and Surgery, School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
- Correspondence: ; Tel.: +39-039-233-3535 or +39-039-233-3538; Fax: +39-039-233-3536
| | - Andrea Cassoni
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I of Rome, 00161 Rome, Italy
- Department of Oral Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Elena De Ponti
- Department of Medical Physics, ASST Monza—San Gerardo Hospital, University of Milano Bicocca, 20900 Monza, Italy
| | - Mattia Moretti
- Maxillofacial Surgery Unit, ASST Monza—San Gerardo Hospital, 20900 Monza, Italy
- Postgraduate School of Maxillofacial Surgery, University of Milan, 20122 Milan, Italy
| | - Resi Pucci
- Department of Oral Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Davide Spadoni
- Maxillofacial Surgery Unit, ASST Santi Paolo e Carlo—Ospedale San Paolo, 20142 Milan, Italy
| | - Gabriele Canzi
- Maxillofacial Surgery Unit, Emergency Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | - Giorgio Novelli
- Maxillofacial Surgery Unit, ASST Monza—San Gerardo Hospital, 20900 Monza, Italy
- Department of Medicine and Surgery, School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Valentino Valentini
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I of Rome, 00161 Rome, Italy
- Department of Oral Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
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Chebil A, Hasnaoui M, Bhar S, Masmoudi M, Bellalah A, Mighri K. Asymptomatic ameloblastoma of the maxilla with infratemporal fossa involvement: A case report. Int J Surg Case Rep 2022; 98:107457. [PMID: 35969907 PMCID: PMC9400081 DOI: 10.1016/j.ijscr.2022.107457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction and importance Diagnosis of odontogenic tumors can be challenging due to their rarity and diverse morphology. The clinical diagnosis could be suspected when it had raised near the tooth. But, when their location is not typical, like inside the paranasal sinuses, the diagnosis is less easy. Maxillary ameloblastomas are rare with only sparse information on their epidemiological, histological and effective management. Case presentation A 54-year-old woman presented with ameloblastoma of the left maxillary sinus. Intraoral examination revealed partially edentulous with a 2 cm painless ulceration of the left alveolar process of the maxilla. A biopsy was performed which showed a follicular ameloblastoma. The treatment was surgical. She had a combined endoscopic and transoral resection of the tumor. The patient was diagnosed with recurrence within 3 months from surgery. Discussion although rarely reported, clinicians should still suspect and know how to manage such as rare and locally invasive tumor as a maxillary ameloblastoma. Conclusions As odontogenic tumors are rare, some entities are infrequently encountered, making the diagnosis more difficult. Clinicians, oral and maxillofacial surgeons, and oral pathologists should be familiar with the ameloblastoma and its differential diagnosis for accurate diagnosis and management. Ameloblastoma is a benign odontogenic tumor of epithelial origin, with locally aggressive behavior. The cases of ameloblastoma in the maxilla jawbone are rare. The Management of ameloblastoma is primarily surgical. High potential of recurrence
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Fiedler LS, Wunsch A. Ameloblastoma of the maxillary sinus: conservative surgical management considering high recurrence risk potential. BMJ Case Rep 2021; 14:14/5/e241487. [PMID: 33986010 PMCID: PMC8126311 DOI: 10.1136/bcr-2020-241487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Ameloblastoma (AM) in the maxillary sinus is rare. This benign entity shows locally invasive, destructive and aggressive behaviour and a high rate of recurrence. Therefore, the course of treatment is radical resection. We report the case of a 38-year-old man presenting with signs of recurrent sinusitis in the Ear, Nose and Throat Department. Transnasal flexible endoscopy revealed a cystic mass in the right inferior and middle nasal passage. CT scan showed an obliterated right maxillary sinus with a ballooning effect and pressure atrophy of the lateral sinus wall, without possible differentiation of the middle and low nasal turbinate. The patient was treated with transnasal functional sinus surgery; pathology stated AM. AM in the maxillary sinus is rare, locally destructive and therefore as a gold standard is resected radically to prevent recurrence. We demonstrate a conservative approach; explicitly, we combined a transvestibular and functional endoscopic sinus surgery resection of the AM to maintain function and reduce the possibility of postoperative impairments. Whether the strategy of treatment for AM is conservative, it nonetheless can result in a recurrence-free status. Nevertheless, inclusion into an oncological follow-up-programme with regularly performed MRI and CT is recommended.
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Affiliation(s)
- Lukas S Fiedler
- Otorhinolaryngology and Head and Neck Surgery, Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier, Deutschland, Germany
| | - Annette Wunsch
- Otorhinolaryngology and Head and Neck Surgery, Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier, Deutschland, Germany
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Milmoe NJ, Tucker AS. Craniofacial transitions: the role of EMT and MET during head development. Development 2021; 148:148/4/dev196030. [DOI: 10.1242/dev.196030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
ABSTRACT
Within the developing head, tissues undergo cell-fate transitions to shape the forming structures. This starts with the neural crest, which undergoes epithelial-to-mesenchymal transition (EMT) to form, amongst other tissues, many of the skeletal tissues of the head. In the eye and ear, these neural crest cells then transform back into an epithelium, via mesenchymal-to-epithelial transition (MET), highlighting the flexibility of this population. Elsewhere in the head, the epithelium loses its integrity and transforms into mesenchyme. Here, we review these craniofacial transitions, looking at why they happen, the factors that trigger them, and the cell and molecular changes they involve. We also discuss the consequences of aberrant EMT and MET in the head.
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Affiliation(s)
- Natalie J. Milmoe
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK
| | - Abigail S. Tucker
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK
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Evangelou Z, Zarachi A, Dumollard JM, Peoc'h M, Komnos I, Kastanioudakis I, Karpathiou G. Maxillary Ameloblastoma: A Review With Clinical, Histological and Prognostic Data of a Rare Tumor. In Vivo 2020; 34:2249-2258. [PMID: 32871747 PMCID: PMC7652510 DOI: 10.21873/invivo.12035] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 01/05/2023]
Abstract
Diagnosis of odontogenic tumors can be challenging due to their rarity and diverse morphology, but when arising near the tooth, the diagnosis could be suspected. When their location is not typical, like inside the paranasal sinuses, the diagnosis is less easy. Maxillary ameloblastomas are exceedingly rare with only sparse information on their epidemiological, histological and genetic characteristics. The aim of this report is to thoroughly review the available literature in order to present the characteristics of this tumor. According to available data, maxillary ameloblastomas can occur in all ages but later than mandible ones, and everywhere within the maxillary region without necessarily having direct contact with the teeth. No sex preference has been shown. The most common histological patterns seen in this location are the follicular and plexiform ones. Maxillary ameloblastomas are locally aggressive neoplasms, thus therapy aims for excision including normal bone beyond the lesion. In contrast to mandible ameloblastomas, maxillary ones most commonly show mutations of the SMO gene. Furthermore, differential tumor diagnosis is thoroughly discussed in the present review.
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Affiliation(s)
- Zoi Evangelou
- Department of Pathology and Otorhinolaryngology, University Hospital of Ioannina, Ioannina, Greece
| | - Athina Zarachi
- Department of Head and Neck Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Jean Marc Dumollard
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Michel Peoc'h
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Ioannis Komnos
- Department of Head and Neck Surgery, University Hospital of Ioannina, Ioannina, Greece
| | | | - Georgia Karpathiou
- Department of Pathology and Otorhinolaryngology, University Hospital of Ioannina, Ioannina, Greece
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
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Abstract
Ameloblastoma is the second most common odontogenic tumor arising in the maxillary bones. The WHO classified ameloblastoma in: solid/multicystic (SMA); unicystic; peripheral and desmoplastic. A conservative or radical approach may be performed for SMA treatment to achieve total excision of the lesion.In this case report, a 47-year-old woman, presented a deformation of the left mandibular region and paresthesia of the left hemi-labium, at the ortopanoramic x-ray (OPT) a multilocular osteolytic lesion and the rhizalysis of dental elements 3.7, 3.6, 3.5, 3.4 and the inclusion of 3.8 was appreciated; the CT exam showed erosion of the mandibular canal roof and of the vestibular cortex in the mental nerve region. The patient was subjected to the extraction of the elements in rhizalysis and of 3.8 and subsequently to the enucleation of the lesion followed by an extensive peripheral ostectomy performed with a piezoelectric device. The patient underwent to OPT and CT examinations follow-up and after 5 years was subjected to implant surgery, at the same time of the implant's placement, bone biopsies were performed using core drills in order to evaluate the bone histologically. The patient showed complete clinical and radiographic healing; the histological examination demonstrates the formation of lamellar bone.
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Yang R, Tang Y, Zhang X, Liu Z, Gokavarapu S, Lin C, Ren Z, Zhou Y, Cao W, Ji T. Recurrence factors in pediatric ameloblastoma: Clinical features and a new classification system. Head Neck 2019; 41:3491-3498. [PMID: 31322781 DOI: 10.1002/hed.25867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 01/27/2019] [Accepted: 06/18/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Ameloblastomas of jaw in the pediatric population are a rare clinical entity and have not been well addressed in the literatures. The present retrospective study analyzed the risk factors associated with recurrence of pediatric ameloblastomas. METHODS Cases of primary pediatric ameloblastomas seen in a tertiary hospital between 2005 and 2015 were analyzed to identify the clinical factors associated with recurrence. RESULTS There were a total of 104 cases of primary pediatric ameloblastomas. The overall mean maximum tumor diameter was 4.11 ± 1.339 cm. The receiver operating characteristic curve and the Youden Index showed an optimal cutoff point of 4.95 cm to accurately predict recurrence. Bone cortex/soft tissue invasion were associated with tumor recurrence (P < .001). CONCLUSIONS The maximum tumor diameter, root resorption, and bone cortex/soft tissue invasion were risk factors for recurrence of pediatric ameloblastomas. The new classification system may serve as a predictor of recurrence in pediatric ameloblastomas.
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Affiliation(s)
- Rong Yang
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Tang
- Department of Stomatology, Tongren Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xu Zhang
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheqi Liu
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sandhya Gokavarapu
- Discipline of Oral and Maxillofacial Surgery, University Dental Cluster, National University Health System (NUHS), Singapore
| | - Chengzhong Lin
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenhu Ren
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongmei Zhou
- Department of Oral Mucosal Diseases, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Cao
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tong Ji
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Zheng CY, Cao R, Hong WS, Sheng MC, Hu YJ. Marsupialisation for the treatment of unicystic ameloblastoma of the mandible: a long-term follow up of 116 cases. Br J Oral Maxillofac Surg 2019; 57:655-662. [PMID: 31230852 DOI: 10.1016/j.bjoms.2019.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 06/05/2019] [Indexed: 12/01/2022]
Abstract
Unicystic ameloblastoma is a unique histopathological type of ameloblastoma, and treatment is controversial. Marsupialisation is effective in reducing the size of cystic lesions and their complications. We have retrospectively analysed the clinical, histopathological, and prognostic data of affected patients who were treated by marsupialisation between 2003 and 2013 in three Chinese hospitals. Our aim was to evaluate the effects and prognosis, and the factors associated with outcome. A total of 116 patients with mandibular unicystic ameloblastomas were included, and 74, 26, and 16 patients were histopathologically classified as being luminal, intraluminal, and mural subtypes, respectively. Most responded well to marsupialisation, with an overall recurrence rate of 12%. Resorption of the root (p<0.001), perforation of the cortical bone (p=0.005), and histopathological subtype (p=0.013) were the main factors that predicted the outcome. Perforation of the cortical bone was the only reliable predictor of recurrence (p<0.001). Disease-free survival function curves indicated that patients with the mural subtype were at a higher risk of recurrence than patients with the other two subtypes (p=0.003). Poor outcomes of marsupialisation were treated surgically and, to date, no subsequent recurrences have been reported. Marsupialisation is effective for these patients, with a recurrence rate similar to that of radical treatment. The outcomes can be predicted using characteristics of the lesion such as resorption of the root, perforation of the cortical bone, and histopathological subtypes. However, additional studies are required to corroborate these findings.
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Affiliation(s)
- C Y Zheng
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Huzhou University, Guangchanghou Road No. 158, Wuxing District, Huzhou, 313000, Zhejiang, PR China.
| | - R Cao
- Department of Oral and Maxillofacial Surgery, Second People's Hospital of Changshu, Haiyunan Road No. 68, Yushan District, Changshu, 215500, Jiangsu, PR China
| | - W S Hong
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Huzhou University, Guangchanghou Road No. 158, Wuxing District, Huzhou, 313000, Zhejiang, PR China
| | - M C Sheng
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Huzhou University, Guangchanghou Road No. 158, Wuxing District, Huzhou, 313000, Zhejiang, PR China
| | - Y J Hu
- Department of Oral-Maxillofacial Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road, No. 639, Huangpu District, Shanghai, 200011, PR China.
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Abstract
Neoplasms of the head and neck constitute a broad spectrum of benign and malignant entities. When treatment involves resection, assessment of the surgical margins represents an important component of the pathologic examination. Margin status is an important indicator of a complete surgical resection. The ability to generalize conclusions such as 'safe distance' measurements from work performed mSCCa or cutaneous malignancy to other types of neoplasms in the head and neck region seems limited. This article reviews conditions and considerations for reliable margin assessment and interpretation.
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