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      Unicystic Ameloblastoma with Mural Proliferation Managed by Conservative Treatment

      case-report

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          Abstract

          Unicystic ameloblastoma is a distinguishable entity of ameloblastomas, characterized by slow growth and being relatively locally aggressive. Three histological types are recognized according to the degree of ameloblastomatous epithelial extension, namely, luminal, intraluminal, and mural types. This classification has a direct bearing on their biological behavior, treatment, and prognosis. However, there is difficulty in determining the most appropriate form of treatment for unicystic ameloblastoma. We present a case of unicystic ameloblastoma that occurred in the right posterior mandible of 19-year-old girl, which was enucleated and did not recur after 12-month follow-up.

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          Unicystic ameloblastoma: A diagnostic dilemma

          Zainab Chaudhary, Vandana Sangwan, U. S. Pal … (2011)
          Ameloblastoma is a slow-growing, persistent and locally aggressive neoplasm of epithelial origin accounting for 10% out of 30% of all odontogenic tumors. According to the World Health Organization, ameloblastomas are classified into the following types: conventional, unicystic, and peripheral. Unicystic ameloblastoma (UA) refers to those cystic lesions that show clinical, radiographic, or gross features of a mandibular cyst, but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. We report a case of young female with a radiolucent lesion in the right posterior mandible. Surgical removal of the lesion was performed, with differential diagnosis of a radicular cyst. However, histopathologic examination revealed UA. The patient was kept under observation and showed signs of local bone regeneration. The purpose of presenting this report of a clinical case of UA previously misdiagnosed as radicular cyst is to emphasize the significance of histopathologic examination of all tissue specimens recovered in surgery even when clinical and radiological finding are innocuous.
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            Retrospective study of ameloblastoma: the possibility of conservative treatment.

            Takumi Hasegawa, Yusuke Imai, Daisuke Takeda … (2013)
            At our institutions, most cases of the solid or multicystic type were treated as conservatively as possible in order to avoid disadvantages of radical treatment. The aim of present study was to retrospectively analyze the ameloblastoma cases diagnosed at our two institutions, to classify them according to the criteria of the 2005 WHO classification, and to evaluate the possibility of using a conservative approach for the surgical treatment of ameloblastoma. Maxillary cases, unicystic cases, peripheral cases and resection-treated cases were excluded from this study. In 23 tumors of mandibular solid or multicystic ameloblastoma, a patient's age, gender, location, clinical signs, duration, radiographic appearance, preoperative diagnosis, ameloblastoma subtypes, treatment, and recurrence were investigated. The recurrence rate (48.7%) in this study was lower than the reported recurrence rate after conservative treatment for solid or multicystic ameloblastoma and was higher than the reported recurrence rate of ameloblastoma, inclusive of other types. However, all patients who were diagnosed with recurrences have maintained their quality of life and were satisfied for at least several years after the conservative treatment. In conclusion, we demonstrated one possibility that a conservative approach might be employed in the surgical treatment of ameloblastoma (even of the solid or multicystic type).
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              Marsupialization of unicystic ameloblastoma: a conservative approach for aggressive odontogenic tumors.

              Dogan Dolanmaz, Osman Etoz, A Pampu … (2024)
              Unicystic ameloblastoma (UA) is known as a distinct entity which has a less aggressive behavior when compared with conventional ameloblastoma. In this report, we have presented two cases of UAs, (of which one case showed a more aggressive behavior with mural invasion into the adjacent tissues and granular cell differentiation), both of which were successfully managed with enucleation following marsupialization. We aim to highlight how this method can be used for the successful management of such cases, rather than following more aggressive approaches. In both the cases, marsupialization was done for the UA lesions initially and follow-ups were maintained. When the tumor size had regressed on radiographic follow up, an enucleation procedure with ostectomy of the margins was carried out. Special importance was also given to the endodontic treatment of the teeth involved in the area of the lesion. The patients were free of the condition and did not show any signs of recurrence on radiographic follow-ups even after 30 months of the final procedure. Granular variant of UA is quite rare and had been considered to be more aggressive. Marsupialization of UA is an alternative treatment option of resection even for more aggressive variants, as long as the histological behavior of the lesion was carefully evaluated and strict radiographic follow-up is maintained.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Case Rep Pathol
                Journal ID (iso-abbrev): Case Rep Pathol
                Journal ID (publisher-id): CRIPA
                Title: Case Reports in Pathology
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-6781
                ISSN (Electronic): 2090-679X
                Publication date (Print): 2016
                Publication date (Electronic): 17 August 2016
                Volume: 2016
                Electronic Location Identifier: 3089540
                Affiliations
                1Department of Stomatology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, 17012-901 Bauru, SP, Brazil
                2Department of Stomatology, Sao Lucas School, 76805-846 Porto Velho, RO, Brazil
                Author notes
                *Natália Galvão Garcia: natggalvao@ 123456hotmail.com

                Academic Editor: Dimosthenis Miliaras

                Author information
                http://orcid.org/0000-0002-1659-8524
                http://orcid.org/0000-0002-4628-7129
                http://orcid.org/0000-0002-4951-5836
                Article
                DOI: 10.1155/2016/3089540
                PMC ID: 5005522
                PubMed ID: 27610259
                SO-VID: f8686113-1537-45a5-a042-161dc4750056
                Copyright © Copyright © 2016 Natália Galvão Garcia et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 18 June 2016
                Date revision received : 19 July 2016
                Date accepted : 27 July 2016
                Funding
                Funded by: CNPq
                Award ID: 141641/2013-4
                Categories
                Subject: Case Report

                Data availability:

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