1
|
Smit C, Robinson L, van Heerden MB, Meyer PW, Ogunsakin RE, Fonseca FP, Uys A, van Heerden WFP. A radiologic-pathologic study of the histopathologic variants of ameloblastomas and their proliferation indices. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(24)00125-1. [PMID: 38871622 DOI: 10.1016/j.oooo.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/23/2024] [Accepted: 03/17/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES This study aimed to analyze the clinicoradiologic features and Ki-67 proliferation indices between the histopathologic variants of ameloblastomas (ABs) for possible associations. STUDY DESIGN The diagnosis and histopathologic variant were confirmed for all cases by experienced Oral and Maxillofacial Pathologists. Immunohistochemistry for Ki-67 was performed on the most representative formalin-fixed paraffin-embedded tissue block. Demographic, clinical data and radiologic features were analyzed from patient records and available radiographic examinations. The investigators were blinded to the histopathologic variant and proliferation index when the clinicoradiologic features were assessed. RESULTS The current study included 116 cases of AB in the final sample. The indolent behavior of the unicystic variant was supported by their low proliferation index and slow growth paired with low frequencies of cortical destruction, loss of teeth, root resorption, and encroachment on anatomical structures. In contrast, the comparatively high proliferation index of the plexiform variant correlated with their fast growth and pain. Furthermore, high radiologic frequencies of cortical destruction, loss of teeth, and encroachment of surrounding anatomical structures supported their more aggressive clinical course. CONCLUSION Statistically significant differences were noted between certain variants and Ki-67, location, borders, locularity, and cortical destruction, providing better insight into their biological behavior.
Collapse
Affiliation(s)
- Chané Smit
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, South Africa.
| | - Liam Robinson
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Marlene B van Heerden
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Pieter W Meyer
- Department of Immunology, Faculty of Health Sciences, University of Pretoria, South Africa; Department of Immunology, Tshwane Academic Division, National Health Laboratory Services, South Africa
| | - Ropo E Ogunsakin
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Felipe P Fonseca
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, South Africa; Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Brazil
| | - André Uys
- Department of Anatomy, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Willie F P van Heerden
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, South Africa
| |
Collapse
|
2
|
Urechescu H, Banu A, Baderca F, Closca RM, Ilas-Tat MB, Urtila F, Pricop M. Ameloblastoma of the Mandible in a 16-Year-Old Female-Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:66. [PMID: 38256328 PMCID: PMC10819258 DOI: 10.3390/medicina60010066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/25/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024]
Abstract
Ameloblastoma is a benign epithelial tumor that has aggressive, destructive and unlimited growth potential, having the capacity for recurrence and malignant transformation. Regarding the symptoms and clinical signs, the presentation of ameloblastoma is poor. In children and young people, ameloblastoma can be difficult to diagnose, because it mimics other benign lesions. Its diagnosis requires a combination of imaging data, histopathological analysis and molecular tests. The methods of treatment consist of radical surgery (segmental resection) and conservative treatments (enucleation with bone curettage). The particularity of the presented case is represented by the late request for medical consultation, a direct consequence of the measures implemented to prevent and control the spread of COVID-19.
Collapse
Affiliation(s)
- Horatiu Urechescu
- Department of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (H.U.); (F.U.); (M.P.)
| | - Ancuta Banu
- Department of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (H.U.); (F.U.); (M.P.)
| | - Flavia Baderca
- Department of Microscopic Morphology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (F.B.); (R.M.C.)
- Angiogenesis Research Center, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- Service of Pathology, Emergency City Hospital, 300254 Timisoara, Romania;
| | - Raluca Maria Closca
- Department of Microscopic Morphology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (F.B.); (R.M.C.)
- Service of Pathology, Emergency City Hospital, 300254 Timisoara, Romania;
| | | | - Florin Urtila
- Department of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (H.U.); (F.U.); (M.P.)
| | - Marius Pricop
- Department of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (H.U.); (F.U.); (M.P.)
| |
Collapse
|
3
|
Yoithapprabhunath TR, Srichinthu KK, Gupta D, Singh D, Pasupuleti S, Nirmal RM. Effectiveness of molecular-targeted chemotherapy in ameloblastomas: A systematic review. Indian J Dent Res 2022; 33:323-331. [PMID: 36656197 DOI: 10.4103/ijdr.ijdr_456_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Ameloblastoma is a benign, locally aggressive neoplasm that needs extensive surgical resection. The goal of this article is to obtain an in-depth review of benign ameloblastomas to determine the available level of evidence and the possible benefit of targeted therapeutics for the treatment of ameloblastoma and BRAF V600E mutation in ameloblastoma. An electronic literature search was conducted according to PRISMA guidelines in PubMed/MEDLINE, EBSCO, and Web of Science for eligible studies published between 1975 and 2021. The systematic review is registered with INPLASY (INPLASY202260018). The review included 2 case series and 17 case reports. The histopathological type, anatomic location, expression of BRAF mutation, additional mutations, and molecular-targeted therapies of the 19 reviewed articles were summarized and tabulated. Interestingly, the majority of the primary site of ameloblastoma was located in the mandible (80.9%) compared to the maxilla (17%). The tumour size was reported in nine of the included studies. Most of the included studies in the review exhibited ameloblastoma with BRAF V600E mutations and responded to molecular-targeted therapies. Molecular therapies employing BRAF and/or MEK inhibitors in ameloblastoma with BRAF V600E mutations proved to be an appropriate treatment based on the limited available evidence. It is essential further to deepen our understanding at the clinical and molecular level to enhance the precision of management of ameloblastoma.
Collapse
Affiliation(s)
| | - Kenniyan K Srichinthu
- Department of Oral and Maxillofacial Pathology, KSR Institute of Dental Science and Research, Tamil Nadu, India
| | - Deepak Gupta
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Haryana, India
| | - Diksha Singh
- Department of Oral and Maxillofacial Pathology, King George Medical College, Uttar Pradesh, India
| | - Swetha Pasupuleti
- Department of Oral and Maxillofacial Pathology, Vishnu Dental College, Andhra Pradesh, India
| | - Ramdas M Nirmal
- Department of Oral and Maxillofacial Pathology, Cuddalore Government Dental College and Hospital, Tamil Nadu, India
| |
Collapse
|
4
|
Chinam N, Vaidya A, Khorate M, Khurana S. A Case Report on Acanthomatous Ameloblastoma of the Anterior Mandible with Brief Review on Advanced Imaging Diagnosis. Indian J Radiol Imaging 2021; 31:1047-1052. [PMID: 35136527 PMCID: PMC8817788 DOI: 10.1055/s-0041-1739382] [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] [Indexed: 11/03/2022] Open
Abstract
AbstractAmeloblastoma is the most common benign odontogenic tumor of epithelial origin. It exhibits a locally aggressive behavior and high recurrence rate with multitude of factors involving in its molecular pathogenesis. This article reports a case of acanthomatous ameloblastoma involving the mandible in a 60-year-old male patient with peculiar imaging characteristics. The role of computed tomography and magnetic resonance imaging in diagnosis of conventional ameloblastoma has been elaborately emphasized in the discussion. Although the final diagnosis is based on histopathological features, physicians should be aware of the role of advanced imaging for diagnosis of ameloblastoma and for better surgical management.
Collapse
Affiliation(s)
- Nivedita Chinam
- Department of Oral Medicine and Radiology, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Aniket Vaidya
- Department of Oral Medicine and Radiology, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Manisha Khorate
- Department of Oral Medicine and Radiology, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Sonam Khurana
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center, San Antonio, Texas, United States
| |
Collapse
|
5
|
Sivakumar M, Yoithapprabhunath TR, Nirmal RM, Veeravarmal V, Dineshshankar J, Amsaveni R. Immunohistochemical analysis of Nuclear Factor-kappa B (NF-κB) between follicular and plexiform ameloblastomas: A pilot study. J Oral Maxillofac Pathol 2021; 24:466-471. [PMID: 33967482 PMCID: PMC8083443 DOI: 10.4103/jomfp.jomfp_150_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 08/13/2020] [Accepted: 09/04/2020] [Indexed: 12/04/2022] Open
Abstract
Background: Ameloblastoma among benign tumors holds a unique position by its locally destructive and invasive nature. Tumors that originate from the odontogenic apparatus or its remnants in the jaws show diverse clinical presentations, behavior and histologic patterns. The differed biological behavior behind follicular and plexiform ameloblastomas has never attained completeness because of the lack of rhythmic correlation regarding the exact mechanism. Nuclear factor-kappa B (NF-κB) pathways play a crucial role in survival, death and differentiation during physiologic and pathologic conditions. With this background, the study has been aimed to investigate the expression of NF-κB in follicular and plexiform ameloblastomas. Objective: The objective of this study was to analyze the immunohistochemical expression pattern of NF-κB in ameloblastoma and to compare the immunohistochemical expression pattern of NF-κB among the histological types of ameloblastoma, follicular and plexiform patterns. Methodology: Total 20 ameloblastomas (10 follicular, 10 plexiform) were immunostained with antihuman NF-κB p65 mouse IgG monoclonal antibody, and the pattern of staining is statistically analyzed using Chi-square test with the level of significance (P < 0.05). Results: Twelve (3 follicular, 9 plexiform) out of 20 ameloblastomas showed immunoreactivity to NF-κB p65. In ameloblastoma, only the peripheral preameloblast-like tall columnar cells showed reactivity, whereas the stellate reticulum-like cells are immunonegative. The staining pattern was membranous in the immunoreactive cells. The results were studied with the associated and inducing pathways from the literature, and a possible mechanism has been proposed. Conclusion: The expression pattern of NF-κB was found to be higher in plexiform ameloblastoma than follicular ameloblastoma.
Collapse
Affiliation(s)
- Muniapillai Sivakumar
- Department of Oral and Maxillofacial Pathology, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | | | - Ramadas Madhavan Nirmal
- Department of Oral and Maxillofacial Pathology, Rajah Muthiah Dental College and Hospital, Chidambaram, Tamil Nadu, India
| | - Veeran Veeravarmal
- Department of Oral and Maxillofacial Pathology, Rajah Muthiah Dental College and Hospital, Chidambaram, Tamil Nadu, India
| | - Janardhanam Dineshshankar
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Namakkal, Tamil Nadu, India
| | - Ramamoorthy Amsaveni
- Department of Oral and Maxillofacial Pathology, Rajah Muthiah Dental College and Hospital, Chidambaram, Tamil Nadu, India
| |
Collapse
|
6
|
Yoithapprabhunath TR, Renugadevi S, Ganapathy N, Dineshshankar J, Yamunadevi A, Nirmal RM. Immunohistochemical Detection of Nerve Growth Factor (NGF) in Follicular and Plexiform Ameloblastoma - A Novel Study. J Pharm Bioallied Sci 2020; 12:S569-S575. [PMID: 33149523 PMCID: PMC7595489 DOI: 10.4103/jpbs.jpbs_185_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background: Ameloblastoma is the second most common odontogenic tumor that holds a unique position among benign tumors due to its locally destructive and invasive nature. The differed tumor biology behind follicular and plexiform ameloblastoma is always an enigma. Nerve growth factor (NGF), a neurotrophin that plays a major role during odontogenesis, could also possibly play a role in the pathogenesis of odontogenic tumors such as ameloblastoma. With this background, the study was aimed to investigate the expression of NGF in follicular and plexiform ameloblastoma. Objectives: The objectives of this study were to analyze the immunohistochemical expression pattern of NGF in ameloblastoma and to compare the immunohistochemical expression pattern of NGF among the follicular and plexiform histological types of ameloblastoma. Materials and Methods: Forty histological sections of ameloblastomas (20 follicular and 20 plexiform) were stained immunohistochemically with anti-human NGF mouse IgG monoclonal antibody and the staining was analyzed statistically. Results: Almost all the 40 ameloblastoma samples (20 follicular and 20 plexiform) showed positive immunoreactivity to NGF. Both peripheral pre-ameloblast-like tall columnar cells and central stellate-reticulum-like cells showed positive reactivity. The pattern of staining was membranous in the immunoreactive cells. The χ2 value for the immunoexpression between follicular and plexiform ameloblastoma was statistically significant with a P value <0.002. A possible mechanism has been proposed after studying the results with the downstream pathways obtained from literature. Conclusion: The pattern of expression of NGF is seen in both follicular and plexiform ameloblastoma. But the intensity is more in plexiform than that of follicular ameloblastoma.
Collapse
Affiliation(s)
| | - Seeni Renugadevi
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Thiruchengodu, Tamil Nadu, India
| | - Nalliappan Ganapathy
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Thiruchengodu, Tamil Nadu, India
| | - Janardhanam Dineshshankar
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Thiruchengodu, Tamil Nadu, India
| | - Andamuthu Yamunadevi
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Thiruchengodu, Tamil Nadu, India
| | - Ramadas Madhavan Nirmal
- Department of Oral and Maxillofacial Pathology, Rajah Muthiah Dental College and Hospital, Chidambaram, Tamil Nadu, India
| |
Collapse
|
7
|
Jisha GB, Ilayaraja V, Yoithapprabhunath TR, Ganapathy N, Dineshshankar J, Nirmal RM. Immunohistochemical detection of Tyrosine Kinase receptor (TrK) in follicular and plexiform ameloblastoma - A novel study. J Oral Maxillofac Pathol 2020; 24:125-130. [PMID: 32508460 PMCID: PMC7269298 DOI: 10.4103/jomfp.jomfp_220_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 01/31/2020] [Indexed: 11/04/2022] Open
Abstract
Objectives: The objective is to analyze the immunohistochemical expression pattern of tyrosine kinase receptor (TrK) in ameloblastoma and to compare the immunohistochemical expression pattern of TrK among the histological types of ameloblastoma, follicular and plexiform patterns. Materials and Methods: Forty ameloblastomas (20 follicular and 20 plexiform) were immunostained with anti-human TrK mouse IgG monoclonal antibody, and the pattern of staining is statistically analyzed. Results: Total 20 (4 follicular and 16 plexiform) out of 40 ameloblastomas showed immunoreactivity to TrK. Only the peripheral preameloblast like tall columnar cells showed reactivity, whereas the stellate reticulum like cells is immunonegative. The staining pattern was membranous in the immunoreactive cells. The Chi-square value for the immunoexpression between follicular and plexiform ameloblastoma was statistically significant with a P < 0.005. The results were studied with the downstream pathways from the literature, and a possible mechanism has been proposed. Conclusion: The expression pattern of TrK is found to be more in plexiform ameloblastoma than follicular ameloblastoma.
Collapse
Affiliation(s)
- George Babu Jisha
- Consultant Oral and Maxillofacial Pathologist, SM Dental Clinic, Erode, Tamil Nadu, India
| | - Vadivel Ilayaraja
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Namakkal, Tamil Nadu, India
| | | | - Nalliappan Ganapathy
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Namakkal, Tamil Nadu, India
| | - Janardhanam Dineshshankar
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Namakkal, Tamil Nadu, India
| | - Ramadas Madhavan Nirmal
- Department of Oral and Maxillofacial Pathology, Rajah Muthiah Dental College and Hospital, Chidambaram, Tamil Nadu, India
| |
Collapse
|