0 evaluări0% au considerat acest document util (0 voturi)
40 vizualizări2 pagini
Ameloblastoma is a slow growing, locally aggressive, odontogenic tumor affecting the maxilla and mandible with a propensity for recurrence. There are many histological variants and all of them clinical present as slow growing pain less swelling in the jaws.
Ameloblastoma is a slow growing, locally aggressive, odontogenic tumor affecting the maxilla and mandible with a propensity for recurrence. There are many histological variants and all of them clinical present as slow growing pain less swelling in the jaws.
Ameloblastoma is a slow growing, locally aggressive, odontogenic tumor affecting the maxilla and mandible with a propensity for recurrence. There are many histological variants and all of them clinical present as slow growing pain less swelling in the jaws.
found in men and mandible. Even though it is a benign tumor it is locally invasive. There are many histological variants and all of them clinical present as slow growing pain less swelling in the jaws. We report a case of an ameloblastoma occurring in the mandible of a 56 year old male. CASE REPORT A 56 years old male was reported our OPD complaining of dull tooth ache in the lower left back teeth region. On examination his face was asymmetrical due to a swelling in the left mandibular ramus region. His medical and personal history was unremarkable. He was moderately built & moderately nourished. Extra orally tenderness was elicited over left angle of mandible on palpation. Submanidibular lymph nodes were palpable and tender on the left side. TMJ was normal. Intra orally left mandibular third molar was missing and second molar was tender to percussion. OPG revealed large multilocular radiolucaecies extending from distal of mandibular second molar and extending posteriorly to involve complete coronoid and condyle on left side of the mandible. CT scan was done and revealed the same lesion with involvement of the lower border of the mandible (Figure 1). Under nasoendotracheal intubation Ameloblastoma CASE REPORT ABSTRACT Ameloblastoma is a slow growing, locally aggressive, odontogenic tumor affecting the maxilla and mandible with a propensity for recurrence. We report an ameloblastoma affecting the mandible in a 56 year old male. The tumor was managed by surgical resection . Key words: odontogenic tumour , ameloblastoma general anaesthesia was induced with the Risdon Insulation, the affected part was exposed and mandible was resected till 34 and titanium reconstruction plate with condylar head was fixed and wound closed in layers (Figure 2). Excised surgical specimen was sent for histopathological investication and reported as follicular ameloblastoma Patient recovered uneventfully. Patient was on regular follow up for six months and noted that there was no infection no exposure of the plate. Patient was rehabilitated with prosthesis. DISCUSSION Ameloblastoma is slow-growing, locally invasive odontogenic tumor with a high rate of recurrence. Clinically they are seen as swellings is the jaws which are generally asymptomatic. There are ten histological variants (table 1), radiographically it can present as a unilocular or multilocular radiolucenices. Irrespective of the histological type their treatment involves surgical excision the only distinction is to perform a conservative surgical approach (enucleating and curettage) or a radical surgical approach, recurrence rates depends upon the type of intervention( conservative surgery recurrence [1] upto 90% and radi cal surgery upto 25%) . [2] Ameloblastoma are common in men and mandible . Surgery for these tumors result in considerable amount of tissue removal and require reconstructive surgeries and rehabilitation. In the present case radical surgery with rehabilitation was performed. It has been suggested tumor angiogenesis may play an important role in locally i nvasi ve aggressi ve bi ol ogi c behavi or of [3] ameloblastoma . Tissue engineering has been reported to be useful in reconstructive surgery for management of Addr ess f or cor r espondence: Dr. Vi shwanath Hi remath E- mai l: dr vshi remath@ gmai l.com Access t hi s ar t i cl e onl i ne Websi te: http:/ / www.ssdctumkur.org/ j dsr.php 19 1 Depar tment of Oral and Maxi llof aci al Surger y Uttaranchal Dental and Medi cal Research Insti tute, Dehradun. 1 1 Chet an B. I , V i shwanat h H i remat h J OURNAL OF DENTAL SCIENCES AND RESEARCH Vol. 3, Issue 1, Pages 19-20 Non pl agi ar i zed Cont ent decl ar at i on pr ovi ded by aut hor Yes Table 1 : Histological variants of ameloblastoma1 Follicular Plexiform Acanthomatous Basal cell Desmoplastic Unicystic Cystic / follicular Follicular / Desmoplastic Follicular / Acanthomatous Follicular / Acanthomatous/Cystic Fig. 1 3D CT showing multilocular lesion is left ramus of mandible Fig.2 Post operative OPG showing titanium plate used for reconstruction [ 4] amel obl astoma . Tumour suppressor genes, ameloblastin, osteoclastic mechanism and matrix metalloproteinases and other signalling molecules are considered to be involved in the pathogenesis of [5] ameloblastoma . REFERENCES 1. Adebiyi KE, Ugboko VI, Omoniyi-Esan GO, Ndukwe KC, Oginni FOClinicopathological analysis of histological variants of ameloblastoma in a suburban Nigerian population. Head Face Med. 2006 Nov 24;2:42. 2. Kim SG, J ang HS. Ameloblastoma: A clinical, radiographic, and histopathologic analysis of 71 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91:649653. 3. Gadbail AR et al Tumor angiogenesis: Role in locally aggressive biological behavior of ameloblastoma and keratocystic odontogenic tumor. Head Neck. 2012 Mar 20. doi: 10.1002/hed.22960. [Epub ahead of print]. 4. Hernandez-Alfaro F, Ruiz-Magaz V, Chatakun P, Guijarro- Martinez R. Mandibular reconstruction with tissue engineering in multiple recurrent ameloblastoma. Int J Periodontics Restorative Dent. 2012 J un;32(3):e82-6. 5. Gomes CC, Duarte AP, Diniz MG, Gomez RS Review article: Current concepts of ameloblastoma pathogenesis J Oral Pathol Med. 2010 Sep;39(8):585-91. 20 J ournal of Dental Sciences and Research