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Luo W, He W, Liang L, Liang Y, Zhang S, Liao G. The 'D-M-C' strategy for conventional ameloblastoma of the mandible: a retrospective study. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00091-2. [PMID: 38670888 DOI: 10.1016/j.ijom.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 04/28/2024]
Abstract
The purpose of this multicentre study was to evaluate the efficacy of the 'dredging-marsupialization-curettage' (D-M-C) strategy in the treatment of conventional intraosseous ameloblastoma of the mandible. A total of 31 patients from three institutions, who had a pathological diagnosis of conventional ameloblastoma of the mandible, were treated with the D-M-C strategy. The surgical protocol comprised a dredging and marsupialization (D-M) step, with additional D-M steps as required. The patients then underwent curettage (C) once an obvious effect of the D-M step had been achieved during follow-up. Eight patients were followed up for ≥36 months but <60 months, while 23 were followed up for ≥60 months. Nineteen of the 23 patients followed up for ≥60 months were disease-free at the last follow-up, with no evidence of recurrence. The D-M step is effective for reducing the tumour size and preserving vital structures. The D-M-C surgical strategy may be a feasible treatment option for conventional ameloblastoma of the mandible.
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Affiliation(s)
- W Luo
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - W He
- Oral and Maxillofacial Surgery Department of Second Affiliated Hospital, School of Medicine, Chinese University of Hong Kong, Shenzhen, and Longgang District People's Hospital of Shenzhen, Shenzhen, China
| | - L Liang
- Department of Oral and Maxillofacial Surgery, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Y Liang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - S Zhang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - G Liao
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Vila S, Oster RA, James S, Morlandt AB, Powell KK, Amm HM. A Retrospective Analysis of 129 Ameloblastoma Cases: Clinical and Demographical Trends from a Single Institution. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01993-3. [PMID: 38607614 DOI: 10.1007/s40615-024-01993-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/23/2024] [Accepted: 03/25/2024] [Indexed: 04/13/2024]
Abstract
Ameloblastomas are benign neoplasms of the jaw, but frequently require extensive surgery. The aim of the study was to analyze the demographic and clinicopathological features of ameloblastoma cases at a single Oral and Maxillofacial Surgery group in the United States. STUDY DESIGN A retrospective chart review of patients evaluated for ameloblastoma between 2010 and 2020 at a single tertiary care center. Age, race, sex, tumor size, tumor location, and histological subtypes were recorded. RESULTS A total of 129 cases of ameloblastoma were recorded with a mean patient age of 42 ± 18.6 years (range 9-91 years old), male to female ratio 1.08:1. Ameloblastoma presenting in the mandible outnumbered maxilla in primary (118 to 8, respectively) and recurrent cases (8 to 1, respectively). There was a higher prevalence of ameloblastoma in Black patients (61.3%) with mean age of Black patients occurring at 40.5 years and the mean age of White patients occurring at 47.8 years and mean tumor size trended larger in the Black patients (15.7 cm2) compared to White patients (11.8 cm2). CONCLUSION Data suggests a strong influence of racial factors on the incidence of ameloblastoma, with regards to size, Black patients with ameloblastoma trended higher and more data is needed to clearly elucidate any relationship between the tumor size and race, as other factors may influence the size (such as time to discovery).
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Affiliation(s)
- Stefan Vila
- Department of Oral & Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, USA
| | - Robert A Oster
- Department of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Sherin James
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, USA
| | - Anthony B Morlandt
- Department of Oral & Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, USA
| | - Kathlyn K Powell
- Department of Oral & Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, USA
| | - Hope M Amm
- Department of Oral & Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, USA.
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Tosios KI, Kalogirou EM, Koutlas IG. Association of MDM2 Overexpression in Ameloblastomas with MDM2 Amplification and BRAF V600E Expression. Int J Mol Sci 2024; 25:2238. [PMID: 38396916 PMCID: PMC10889355 DOI: 10.3390/ijms25042238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
Ameloblastoma is a rare tumor but represents the most common odontogenic neoplasm. It is localized in the jaws and, although it is a benign, slow-growing tumor, it has an aggressive local behavior and high recurrence rate. Therefore, alternative treatment options or complementary to surgery have been evaluated, with the most promising one among them being a targeted therapy with the v-Raf murine sarcoma viral oncogene homologue B (BRAF), as in ameloblastoma the activating mutation V600E in BRAF is common. Studies in other tumors have shown that the synchronous inhibition of BRAF and human murine double minute 2 homologue (MDM2 or HDM2) protein is more effective than BRAF monotherapy, particularly in the presence of wild type p53 (WTp53). To investigate the MDM2 protein expression and gene amplification in ameloblastoma, in association with BRAFV600E and p53 expression. Forty-four cases of ameloblastoma fixed in 10% buffered formalin and embedded in paraffin were examined for MDM2 overexpression and BRAFV600E and p53 expression by immunohistochemistry, and for MDM2 ploidy with fluorescence in situ hybridization. Sixteen of forty-four (36.36%) cases of ameloblastoma showed MDM2 overexpression. Seven of sixteen MDM2-positive ameloblastomas (43.75%) were BRAFV600E positive and fifteen of sixteen MDM2-positive ameloblastomas (93.75%) were p53 negative. All MDM2 overexpressing tumors did not show copy number alterations for MDM2. Overexpression of MDM2 in ameloblastomas is not associated with MDM2 amplification, but most probably with MAPK activation and WTp53 expression. Further verification of those findings could form the basis for the use of MDM2 expression as a marker of MAPK activation in ameloblastomas and the trial of dual BRAF/MDM2 inhibition in the management of MDM2-overexpressing/BRAFV600E-positive/WTp53 ameloblastomas.
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Affiliation(s)
- Konstantinos I. Tosios
- Department of Oral Pathology & Medicine and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Eleni-Marina Kalogirou
- Faculty of Health and Rehabilitation Sciences, Metropolitan College, 15125 Athens, Greece;
| | - Ioannis G. Koutlas
- Division of Oral Pathology, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA;
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Smit C, Robinson L, Ker-Fox J, Fonseca FP, van Heerden WFP, Uys A. Clinicoradiologic features of ameloblastomas: A single-centre study of 155 cases. J Oral Pathol Med 2024; 53:133-141. [PMID: 38212674 DOI: 10.1111/jop.13510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND The purpose of the current study was to report on the clinical presentation and radiologic features of 155 cases of ameloblastoma (AB), representing a detailed, large, single-centre radiologic study. METHODS Histologically confirmed cases were reviewed over 11 years. Demographic and clinical data were retrieved from the patient's records. Radiologic information was analysed from available radiographs. The radiologic features of ABs were assessed according to the mean age of presentation and the mean duration of the lesion. The distinguishing radiologic features between adults/children and sex were also evaluated. RESULTS A statistically significant correlation existed between loss of border demarcation and advanced mean age. Multilocular lesions were markedly more common in adults compared to children. Multilocular ABs were associated with increased lesion duration and advanced mean age. Radiologic signs of reactive bony changes associated with the tumour presented at the highest mean duration of all bony effects. Bony expansion and cortical destruction were statistically correlated with lesion duration. Tooth impaction was more common in children. Some mandibular lesions reached a significant size, resulting in impingement of the maxillary sinus, zygoma, orbit and pterygoid plates. CONCLUSION Due to unfortunate healthcare access constraints, ABs grow to significant sizes and exhibit features not often reported in the literature. The findings of this analysis highlighted the radiologic features of ABs expressed through the mean age and duration of the lesion. This emphasises the significance of timely management of these lesions.
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Affiliation(s)
- Chané Smit
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Liam Robinson
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Felipe Paiva Fonseca
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Willie F P van Heerden
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - André Uys
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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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.
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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.)
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Shen W, Xu C, Wang P, Chen J, Yu D, Zhu H. Giant Mandibular Ameloblastoma with Rare Hypercalcemia: A Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1956. [PMID: 38004005 PMCID: PMC10673442 DOI: 10.3390/medicina59111956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/18/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023]
Abstract
Ameloblastoma is the most common benign odontogenic tumor with local invasion and high recurrence, which generally occurs in the jaw bones. Hypercalcemia is a common paraneoplastic syndrome that is commonly observed in patients with malignancies but rarely encountered in patients with benign tumors. Thus far, not many cases of ameloblastoma with hypercalcemia have been reported, and the pathogenic mechanism has not been studied in depth. This paper presents a case report of a 26-year-old male diagnosed with giant ameloblastoma of the mandible, accompanied by rare hypercalcemia. Additionally, a review of the relevant literature is conducted. This patient initially underwent marsupialization, yet this treatment was not effective, which indicated that the selection of the appropriate operation is of prime importance for improving the prognosis of patients with ameloblastoma. The tumor not only failed to shrink but gradually increased in size, accompanied by multiple complications including hypercalcemia, renal dysfunction, anemia, and cachexia. Due to the contradiction between the necessity of tumor resection and the patient's poor systemic condition, we implemented a multi-disciplinary team (MDT) meeting to better evaluate this patient's condition and design an individualized treatment strategy. The patient subsequently received a variety of interventions to improve the general conditions until he could tolerate surgery, and finally underwent the successful resection of giant ameloblastoma and reconstruction with vascularized fibular flap. No tumor recurrence or distance metastasis was observed during 5 years of follow-up. Additionally, the absence of hypercalcemia recurrence was also noted.
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Affiliation(s)
- Wenyi Shen
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Chenlu Xu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Pan Wang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Junpeng Chen
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Dan Yu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Huiyong Zhu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
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Giraldo-Roldan D, Ribeiro ECC, Araújo ALD, Penafort PVM, Silva VMD, Câmara J, Pontes HAR, Martins MD, Oliveira MC, Santos-Silva AR, Lopes MA, Kowalski LP, Moraes MC, Vargas PA. Deep learning applied to the histopathological diagnosis of ameloblastomas and ameloblastic carcinomas. J Oral Pathol Med 2023; 52:988-995. [PMID: 37712132 DOI: 10.1111/jop.13481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/08/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Odontogenic tumors (OT) are composed of heterogeneous lesions, which can be benign or malignant, with different behavior and histology. Within this classification, ameloblastoma and ameloblastic carcinoma (AC) represent a diagnostic challenge in daily histopathological practice due to their similar characteristics and the limitations that incisional biopsies represent. From these premises, we wanted to test the usefulness of models based on artificial intelligence (AI) in the field of oral and maxillofacial pathology for differential diagnosis. The main advantages of integrating Machine Learning (ML) with microscopic and radiographic imaging is the ability to significantly reduce intra-and inter observer variability and improve diagnostic objectivity and reproducibility. METHODS Thirty Digitized slides were collected from different diagnostic centers of oral pathology in Brazil. After performing manual annotation in the region of interest, the images were segmented and fragmented into small patches. In the supervised learning methodology for image classification, three models (ResNet50, DenseNet, and VGG16) were focus of investigation to provide the probability of an image being classified as class0 (i.e., ameloblastoma) or class1 (i.e., Ameloblastic carcinoma). RESULTS The training and validation metrics did not show convergence, characterizing overfitting. However, the test results were satisfactory, with an average for ResNet50 of 0.75, 0.71, 0.84, 0.65, and 0.77 for accuracy, precision, sensitivity, specificity, and F1-score, respectively. CONCLUSIONS The models demonstrated a strong potential of learning, but lack of generalization ability. The models learn fast, reaching a training accuracy of 98%. The evaluation process showed instability in validation; however, acceptable performance in the testing process, which may be due to the small data set. This first investigation opens an opportunity for expanding collaboration to incorporate more complementary data; as well as, developing and evaluating new alternative models.
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Affiliation(s)
- Daniela Giraldo-Roldan
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | | | | | | | - Viviane Mariano da Silva
- Institute of Science and Technology, Federal University of São Paulo (ICT-Unifesp), São José dos Campos, Brazil
| | - Jeconias Câmara
- Department of Pathology and Legal Medicine, School of Medicine, Federal University of Amazon, Manaus, Brazil
| | | | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Márcio Campos Oliveira
- Department of Health, State University of Feira de Santana (UEFS), Feira de Santana, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Marcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Luiz Paulo Kowalski
- Head and Neck Surgery Department, University of São Paulo Medical School, São Paulo, Brazil
| | - Matheus Cardoso Moraes
- Institute of Science and Technology, Federal University of São Paulo (ICT-Unifesp), São José dos Campos, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
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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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Correa-Arzate L, Portilla-Robertson J, Ramírez-Jarquín JO, Jacinto-Alemán LF, Mejía-Velázquez CP, Villanueva-Sánchez FG, Rodríguez-Vázquez M. LRP5, SLC6A3, and SOX10 Expression in Conventional Ameloblastoma. Genes (Basel) 2023; 14:1524. [PMID: 37628576 PMCID: PMC10453908 DOI: 10.3390/genes14081524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
Cell proliferation and invasion are characteristic of many tumors, including ameloblastoma, and are important features to target in possible future therapeutic applications. OBJECTIVE The objective of this study was the identification of key genes and inhibitory drugs related to the cell proliferation and invasion of ameloblastoma using bioinformatic analysis. METHODS The H10KA_07_38 gene profile database was analyzed by Rstudio and ShinyGO Gene Ontology enrichment. String, Cytoscape-MCODE, and Kaplan-Meier plots were generated, which were subsequently validated by RT-qPCR relative expression and immunoexpression analyses. To propose specific inhibitory drugs, a bioinformatic search using Drug Gene Budger and DrugBank was performed. RESULTS A total of 204 significantly upregulated genes were identified. Gene ontology enrichment analysis identified four pathways related to cell proliferation and cell invasion. A total of 37 genes were involved in these pathways, and 11 genes showed an MCODE score of ≥0.4; however, only SLC6A3, SOX10, and LRP5 were negatively associated with overall survival (HR = 1.49 (p = 0.0072), HR = 1.55 (p = 0.0018), and HR = 1.38 (p = 0.025), respectively). The RT-qPCR results confirmed the significant differences in expression, with overexpression of >2 for SLC6A3 and SOX10. The immunoexpression analysis indicated positive LRP5 and SLC6A3 expression. The inhibitory drugs bioinformatically obtained for the above three genes were parthenolide and vorinostat. CONCLUSIONS We identify LRP5, SLC6A3, and SOX10 as potentially important genes related to cell proliferation and invasion in the pathogenesis of ameloblastomas, along with both parthenolide and vorinostat as inhibitory drugs that could be further investigated for the development of novel therapeutic approaches against ameloblastoma.
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Affiliation(s)
- Lorena Correa-Arzate
- Department of Oral Medicine and Pathology, Postgraduate Division, Dental School, National Autonomous University of Mexico, Mexico City 04510, Mexico (J.P.-R.); (C.P.M.-V.)
| | - Javier Portilla-Robertson
- Department of Oral Medicine and Pathology, Postgraduate Division, Dental School, National Autonomous University of Mexico, Mexico City 04510, Mexico (J.P.-R.); (C.P.M.-V.)
| | - Josué Orlando Ramírez-Jarquín
- Neurosciences Division, Cellular Physiology Institute, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Luis Fernando Jacinto-Alemán
- Department of Oral Medicine and Pathology, Postgraduate Division, Dental School, National Autonomous University of Mexico, Mexico City 04510, Mexico (J.P.-R.); (C.P.M.-V.)
| | - Claudia Patricia Mejía-Velázquez
- Department of Oral Medicine and Pathology, Postgraduate Division, Dental School, National Autonomous University of Mexico, Mexico City 04510, Mexico (J.P.-R.); (C.P.M.-V.)
| | | | - Mariana Rodríguez-Vázquez
- Infectomic and Molecular Pathogenesis Department, CINVESTAV, National Polytechnic Institute, Mexico City 07738, Mexico;
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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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Tabrizi R, Alam M, Amoular E, Malekigorji M. Does Preservation of the Inferior Alveolar Nerve in the Close Margin of the Mandibular Ameloblastoma Increase the Risk of Recurrence? J Oral Maxillofac Surg 2023; 81:101-106. [PMID: 36257340 DOI: 10.1016/j.joms.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/11/2022] [Accepted: 09/11/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE Preservation of the inferior alveolar nerve (IAN) during mandibular resection improves the patient's quality of life. This study aimed to assess the risk of recurrence in patients with or without IAN preservation following mandibular resection for the treatment of ameloblastoma. METHODS In this retrospective cohort study, patients with biopsy-proven, intraosseous, multicystic ameloblastoma in the mandible, without IAN involvement, were included. The minimum follow-up period was 36 months. In preserved group, the IAN was saved in the close margin, and the IAN was resected in the sacrificed group. The mandibular nerve management (preservation or sacrifice of the IAN) was a primary predictive variable. The primary outcome variable was time to recurrence of the jaw lesion. Age, sex, tumor size, and ameloblastoma histological subtype were covariates. A time-to-event analysis (Cox regression analysis) was performed to determine the risk of recurrence with or without preservation of the IAN. RESULTS Thirty-seven patients in the preserved group and 38 in the sacrificed group were included in this study. The median follow-up period was 43 months. The mean tumor size was 3.88 ± 0.89 cm in the preserved group, and the mean tumor size was 3.74 ± 0.56 cm in the sacrificed group. There was no significant difference in the mean tumor size between the 2 groups. The time-to-event analysis, based on the Cox regression analysis of covariates, did not approve the study's null hypothesis (an increased recurrence with IAN preservation; hazard ratio: 0.77 [0.20-2.93]; P = .71). CONCLUSION Based on the present results, preservation or sacrifice of the IAN in the close margin of mandibular ameloblastoma was not associated with an increased recurrence of lesions.
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Affiliation(s)
- Reza Tabrizi
- Associate Professor of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mostafa Alam
- Assistant Professor of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Erfan Amoular
- Dentist, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Malekigorji
- Fellowship of Reconstruction, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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89Zr-panitumumab PET imaging for preoperative assessment of ameloblastoma in a PDX model. Sci Rep 2022; 12:19187. [PMID: 36357495 PMCID: PMC9649768 DOI: 10.1038/s41598-022-23531-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022] Open
Abstract
Accurate assessment of tumor margins with specific, non-invasive imaging would result in the preservation of healthy tissue and improve long-term local tumor control, thereby reducing the risk of recurrence. Overexpression of epidermal growth factor receptor (EGFR) has been used in other cancers as an imaging biomarker to identify cancerous tissue. We hypothesize that expression of EGFR in ameloblastomas may be used to specifically visualize tumors. The aims of this study are to measure the specificity of radiolabeled 89Zr-panitumumab (an EGFR antibody) in vivo using patient-derived xenograft (PDX) models of ameloblastoma and positron emission tomography/computed tomography (PET/CT) scans. In PDX of ameloblastomas from four patients (AB-36, AB-37, AB-39 AB-53), the biodistribution of 89Zr-panitumumab was measured 120 h post-injection and was reported as the injected dose per gram of tissue (%ID/g; AB-36, 40%; AB-37, 62%; AB-39 18%; AB-53, 65%). The radiolabeled %ID/g was significantly greater in tumors of 89Zr-panitumumab-treated mice that did not receive unlabeled panitumumab as a blocking control for AB-36, AB-37, and AB-53. Radiolabeled anti-EGFR demonstrates specificity for ameloblastoma PDX tumor xenografts, we believe 89Zr-panitumumab is an attractive target for pre-surgical imaging of ameloblastomas. With this technology, we could more accurately assess tumor margins for the surgical removal of ameloblastomas.
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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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Recurrent Ameloblastoma: Clinical Manifestation and Disease-Free Survival Rate. JOURNAL OF ONCOLOGY 2022; 2022:2148086. [PMID: 35983087 PMCID: PMC9381261 DOI: 10.1155/2022/2148086] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 06/19/2022] [Accepted: 06/23/2022] [Indexed: 11/17/2022]
Abstract
Objectives Ameloblastoma is a slow-growing epithelial odontogenic neoplasm of the jaws with a high recurrence rate. The main treatment strategies for this lesion are radical or conservative surgical approaches. The aim of the present study was to analyze clinical presentations, histological types, and treatment strategies of recurrent ameloblastoma and to define its disease-free survival (DFS) rate. Materials and Methods Twenty-four cases of recurrent ameloblastomas, treated between January 2009 and July 2021, were enrolled in this study. Medical files from each patient, including gender, age, size of the lesion, localization, patient complaints, clinical manifestation, radiographic appearance, histological type, surgical management, and treatment results were reviewed and analyzed retrospectively. Result Out of 69 operated primary ameloblastomas, the rate of recurrence was 35%. Out of 24 recurrent cases, 21 developed after conservative treatment and 3 after radical treatment. In most cases, recurrences were found in the mandible (n = 20). A unilocular pattern was predominant in radiographic examination (44%). Estimated 3-year DFS was 84.5 ± 4.8%, and the 5-year and 10-year DFS were 73.0 ± 6.3% and 43.9 ± 8.343.9 ± 8.3%, respectively. Conclusion Results obtained in the present retrospective study proved the necessity of long-term follow-up after both conservative and radical treatment approaches. The DFS median in our study was 8 years (95% CI 6 years–10 years). For recurrent cases, radical resection with histologically free margins after exact MRI determination of the ameloblastoma border within the soft tissues should be considered as the method of choice to avoid secondary recurrence.
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Robinson L, Smit C, Fonseca FP, Abrahão AC, Romañach MJ, Khurram SA, Hunter KD, Speight PM, van Heerden WFP. Keratoameloblastoma: A Report of Seven New Cases and Review of Literature. Head Neck Pathol 2022; 16:1103-1113. [PMID: 35861917 PMCID: PMC9729669 DOI: 10.1007/s12105-022-01470-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/16/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Keratoameloblastoma (KA) is an uncommon and controversial variant of ameloblastoma exhibiting central keratinisation. Due to their rarity, there is limited information in the literature on their clinical, radiologic and histologic features. This study adds seven additional cases of KA to the literature, and reviews the current published literature on this rare entity. METHODS KAs were retrospectively reviewed over a 20-year period from three Oral and Maxillofacial Pathology Laboratories. Included cases were examined and the diagnosis confirmed under conventional microscopy. Immunohistochemistry with the use of a monoclonal antibody against calretinin was performed on included cases. The clinical, radiologic and histologic features of the seven new cases of KA were analysed and compared to existing cases in the literature. RESULTS KAs presented at a mean age of 40 years with a nearly equal gender distribution and a mandibular predilection (65%). The majority (92%) of cases presented with localised swelling with associated pain in 32% of cases. Mixed density or internal calcifications were noted in 40% of cases. All tumours presented with bony expansion, with cortical destruction noted in 62% of cases. Histologically, all tumours consisted of solid and cystic follicles with surface parakeratinisation and lamellated accumulations of central keratin. In areas the cystic follicles had an epithelial lining suggestive of an OKC. There were focal luminal areas of loosely arranged polygonal cells reminiscent of the stellate reticulum. The basal cells consisted of columnar cells with evidence of palisading and prominent subnuclear vacuolisation. Of the cases treated via tumour resection, 27% presented with tumour recurrence. CONCLUSION This case series reports seven additional cases of KA, taking the total to 26 reported cases. The identification of subtle histologic features, including focal stellate reticulum-like central areas, subnuclear vacuolisation and lamellated-type central keratinisation, are key in diagnosing KA. The radiologic features will often indicate signs of aggressiveness such as cortical destruction, differentiating KA from OKC. All cases were completely negative for calretinin IHC, limiting its use in distinguishing KA from OKC. Further large series are needed to expand the current understanding of this rare variant of ameloblastoma.
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Affiliation(s)
- Liam Robinson
- grid.49697.350000 0001 2107 2298Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Chané Smit
- grid.49697.350000 0001 2107 2298Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Felipe Paiva Fonseca
- grid.49697.350000 0001 2107 2298Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa ,grid.8430.f0000 0001 2181 4888Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Aline Corrêa Abrahão
- grid.8536.80000 0001 2294 473XDepartment of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mário José Romañach
- grid.8536.80000 0001 2294 473XDepartment of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Syed Ali Khurram
- grid.11835.3e0000 0004 1936 9262Academic Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Keith D. Hunter
- grid.49697.350000 0001 2107 2298Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa ,grid.10025.360000 0004 1936 8470Molecular and Clinical Cancer Medicine Unit, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Paul M. Speight
- grid.11835.3e0000 0004 1936 9262Emeritus Professor in Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Willie F. P. van Heerden
- grid.49697.350000 0001 2107 2298Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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16
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Li S, Kim HY, Lee DJ, Park SH, Otsu K, Harada H, Jung YS, Jung HS. Inhibition of L-type voltage-gated calcium channel-mediated Ca 2+ influx suppresses the collective migration and invasion of ameloblastoma. Cell Prolif 2022; 55:e13305. [PMID: 35794842 PMCID: PMC9628225 DOI: 10.1111/cpr.13305] [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: 05/02/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives Ameloblastoma (AM) has been known as a benign but locally invasive tumour with high recurrence rates. Invasive behaviour of the AM results in destruction of the adjacent jawbone and the non‐detectable remnants during surgery, interrupting the complete elimination of cancer cells. Methods To explore novel targets for the tumour cell invasion, a transcriptomic analysis between AM and odontogenic keratocyst were performed through next‐generation sequencing in detail. Results Enrichment of CACNA1C gene (encoding Cav1.2) in AM, a subunit of the L‐type voltage‐gated calcium channel (VGCC) was observed for the first time. The expression and channel activity of Cav1.2 was confirmed by immunostaining and calcium imaging in the patient samples or primary cells. Verapamil, L‐type VGCC blocker revealed suppression of the Ca2+‐induced cell aggregation and collective invasion of AM cells in vitro. Furthermore, the effect of verapamil in suppressing AM invasion into the adjacent bone was confirmed through orthotopic xenograft model specifically. Conclusion Taken together, Cav1.2 maybe considered to be a therapeutic candidate to decrease the collective migration and invasion of AM.
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Affiliation(s)
- Shujin Li
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Taste Research Center, Oral Science Research Center, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Hyun-Yi Kim
- NGeneS Inc, Ansan-si, Gyeonggi-do, South Korea
| | - Dong-Joon Lee
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Taste Research Center, Oral Science Research Center, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Sung-Ho Park
- Department of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, South Korea
| | - Keishi Otsu
- Division of Developmental Biology and Regenerative Medicine, Department of Anatomy, Iwate Medical University, Iwate, Japan
| | - Hidemitsu Harada
- Division of Developmental Biology and Regenerative Medicine, Department of Anatomy, Iwate Medical University, Iwate, Japan
| | - Young-Soo Jung
- Department of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, South Korea
| | - Han-Sung Jung
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Taste Research Center, Oral Science Research Center, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
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Zhang Y, Li X, Zhang Y, Ye Y, Pan X, Hu T, Chen W, Chai H, Wang X, Yang Y. Carbon ion radiotherapy for recurrent ameloblastoma: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221082416. [PMID: 35355852 PMCID: PMC8958705 DOI: 10.1177/2050313x221082416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 02/06/2022] [Indexed: 11/30/2022] Open
Abstract
Ameloblastoma is a kind of benign, odontogenic tumor of epithelial origin, and surgery is mainstay treatment method; however, recurrence is common, and usually the treatment for recurrence is still surgery. We report on a patient of recurrent ameloblastoma treated with carbon ion radiation therapy and achieved a good efficacy. A 25-year-old female with relapse of an ameloblastoma was referred to the Wuwei Heavy Ion Center for carbon ion therapy. She had been initially diagnosed with ameloblastoma 8 years ago and underwent operation of right mandible ameloblastoma. After she transferred to our center, she accepted a dose of 60 GyE carbon ion radiation therapy, and the efficacy is good. Carbon ion radiation therapy can be an effective treatment option for ameloblastoma.
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Affiliation(s)
- Yihe Zhang
- Heavy Ion Radiotherapy of Wuwei Tumor Hospital, Wuwei, China
| | | | | | - Yancheng Ye
- Heavy Ion Radiotherapy of Wuwei Tumor Hospital, Wuwei, China
| | - Xin Pan
- Heavy Ion Radiotherapy of Wuwei Tumor Hospital, Wuwei, China
| | - Tingchao Hu
- Heavy Ion Radiotherapy of Wuwei Tumor Hospital, Wuwei, China
| | - Weizuo Chen
- Heavy Ion Radiotherapy of Wuwei Tumor Hospital, Wuwei, China
| | - Hongyu Chai
- Heavy Ion Radiotherapy of Wuwei Tumor Hospital, Wuwei, China
| | - Xin Wang
- Heavy Ion Radiotherapy of Wuwei Tumor Hospital, Wuwei, China
| | - Yuling Yang
- Heavy Ion Radiotherapy of Wuwei Tumor Hospital, Wuwei, China
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Ajila V, Hegde S. Ameloblastomas vs recurrent ameloblastomas: a systematic review. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2022. [DOI: 10.1051/mbcb/2021044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Ameloblastoma is an odontogenic tumour with high recurrence rate. The objective of the present study was to evaluate existing literature regarding clinical, radiographic, histopathologic features, treatment, and recurrence rate of ameloblastomas and compare it with features of recurrent ameloblastomas. Materials and methods: A systematic review was done based on the PRISMA statement. Search was performed in “Pubmed” database with search terminology “recurrent ameloblastoma”, “ameloblastoma recurrence” for articles published between 2010 and 2020. Data were extracted from full‐text articles and discussed. Results: Out of 515 articles, 16 articles fulfilled the inclusion and exclusion criteria. Data was analysed in two sections. The first with 10 publications assessed features of ameloblastoma in general and their recurrence rate while the second section evaluated features of only recurrent ameloblastomas in 6 publications. There were 234 recurrences in 936 cases with recurrence rate of 23.50%. Male predominance was noted and mandible was commonly affected. Solid/multicystic ameloblastomas formed 74.5% of the tumours and unicystic formed 23.3%. The recurrence rate after conservative treatment was 64.9% and after radical treatment was 12%. Conclusions: The main factors for recurrence were multilocular ameloblastomas, follicular histopathology and conservative treatment.
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19
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Fibular Free Flap and Iliac Crest Free Flap Mandibular Reconstruction In Patients With Mandibular Ameloblastomas. J Craniofac Surg 2022; 33:1962-1970. [PMID: 35175985 DOI: 10.1097/scs.0000000000008524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/14/2022] [Indexed: 10/19/2022] Open
Abstract
ABSTRACT Ameloblastoma (AM) is the most common, locally aggressive odontogenic tumor. It comprises about 1% of all head and neck neoplasms. It occurs mainly in young adults in their 3rd and 4th decade of life. It localizes in the mandible in about 80% of the cases. According to the 2017 WHO classification, 4 types of ameloblastoma can be distinguished: ameloblastoma (previously referred to as solid/multicystic-SMA; the "conventional type" AM), unicystic (AM-UA), extraosseous/peripheral (AM-PA), and malignant/metastatic (AM-MA). Solid, multicystic is the most common type. It is characteristic for its aggressiveness and high risk of recurrence. Radical resection with consecutive reconstruction is the treatment of choice of mandibular ameloblastomas.In this study, the authors present their experience in the surgical treatment of mandibular ameloblastomas with vascularized free flap reconstructions. They discuss new technological possibilities that could improve the precision of the reconstructive procedure and therefore result in the better aesthetic outcome.The retrospective study of a group of 21 patients suffering from mandibular ameloblastoma who underwent segmental mandibulectomy with simultaneous microvascular free flap reconstruction was conducted. A thorough clinical analysis with various aspects was performed. Tumors resected before 2017 were double checked patomorphologically and assigned to the corrected subtype group.Seven patients were admitted to the department due to recurrent ameloblastoma. The most common localization of the tumor was the mandibular body (n = 6) and body with ramus of the mandible (n = 6). A total amount of 10 iliac crest free flaps and 12 fibular free flaps were performed. Complications were reported in 4 patients. A purulent oro-cutaneus fistula occurred in 3patients. There was a flap failure in each reconstructive group. The virtual surgical planning with intraoperative cone-beam computed tomography was used in 3 patients. Dentition implantation was conducted in 4 patients (3 simultaneously, 1 postponed). The mean follow-up was 5 years and 8 months.Radical resection that covers radical segmental mandibulectomy with immediate microvascular free flap reconstruction is a first-line and only effective treatment of mandibular ameloblastomas, that eliminates the risk of recurrence. The extent of surgical margins seems not to influence the recurrence rate, yet further investigation with statistical analysis should be performed. The choice of the adequate free flap must be adapted to dimensions and localization of the tumor and to each patient individually.New technologies such as virtual surgical planning with 3D models and intraoperativecone-beam computed tomography can make the reconstruction more accurate, improving patient's quality of life.
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JACINTO-ALEMÁN LF, PORTILLA-ROBERTSON J, LEYVA-HUERTA ER, RAMÍREZ-JARQUÍN JO, VILLANUEVA-SÁNCHEZ FG. Microarray and bioinformatic analysis of conventional ameloblastoma: an observational analysis. J Appl Oral Sci 2022. [DOI: 10.1590/1678-7757-2022-0308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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21
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Wang R, Li KY, Su YX. Prediction of ameloblastoma recurrence using random forest-a machine learning algorithm. Int J Oral Maxillofac Surg 2021; 51:886-891. [PMID: 34920910 DOI: 10.1016/j.ijom.2021.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 09/11/2021] [Accepted: 11/30/2021] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to investigate whether ameloblastoma with a high likelihood of recurrence can be predicted using random forest model, a machine learning algorithm. Data were collected from patients treated for ameloblastoma between 1999 and 2019 at the University of Hong Kong. Fourteen clinical parameters were used to grow the decision trees to classify patients with or without ameloblastoma recurrence in the follow-up period. The random forest algorithm was computed 100 times in the training cohort (n = 100) and verified in the testing cohort (n = 50). The receiver operating characteristic curve (ROC) and area under the curve (AUC) were used as the performance measurement of separability. One hundred and fifty patients (76 female, 74 male) were recruited, with a mean follow-up time of 103 months. Recurrence occurred in a total of 25 cases (16.7%) over the 20-year period. The AUC were calculated for the median and mean ROC curves; these were 0.777 and 0.825, respectively. The results showed that random forest model was able to predict recurrence of ameloblastoma with reliable accuracy. The four most important variables influencing ameloblastoma recurrence were the time elapsed from treatment, initial surgical treatment, tumour size, and radiographic presentation. This study provides insights into the detection of high-risk patient groups to monitor recurrence. Further application of random forest to other diseases could greatly benefit clinical decisions.
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Affiliation(s)
- R Wang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - K Y Li
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Y-X Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
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22
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Bwambale P, Yahaya JJ, Owor G, Wabinga H. Histopathological patterns and biological characteristics of ameloblastoma: A retrospective cross-sectional study. J Taibah Univ Med Sci 2021; 17:96-104. [PMID: 35140571 PMCID: PMC8801468 DOI: 10.1016/j.jtumed.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives This study aims to determine the histopathological patterns and biological characteristics of ameloblastoma. Methods This was a cross-sectional retrospective laboratory-based study using 82 formalin-fixed paraffin-embedded tissue blocks from patients diagnosed histologically with ameloblastoma. Information regarding age, sex, anatomical location of the lesion, histopathologic type, and biological behaviour or characteristics of the types of ameloblastoma was obtained from laboratory request forms. Categorical and continuous variables were summarized in percentage and mean ± standard deviation, respectively. The cohort was conducted on Ugandan patients diagnosed between 2016 and 2019. Results Most patients (66.3%) were clinically presenting a painless jaw swelling, and a follicular pattern was common (39%) followed by the plexiform pattern (12.2%). All the ameloblastoma cases (100%) were benign, with the majority (76.8%) cases being non-recurrent while the remaining (23.2%) were recurrent, and the plexiform pattern was the commonest recurrent histopathological pattern. Conclusion This study reports a relatively significant rate of recurrence in almost a quarter of the study population. The plexiform histopathologic type was the dominant type in recurrence cases. Therefore, this finding provides insightful information to clinicians to ensure close follow-up for patients diagnosed with such a variant to prevent possible relapse of the disease.
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Alloplastic Temporomandibular Joint Reconstruction Following Recurrent Ameloblastoma Resection. J Craniofac Surg 2021; 33:284-288. [PMID: 34510060 DOI: 10.1097/scs.0000000000008124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Ameloblastomas are benign tumors that most commonly affecting the mandible. The current standard of treatment for ameloblastomas is resection followed by reconstruction that has historically been accomplished through the use of a microsurgical vascularized flaps taken from the iliac crest or fibula. Alloplastic reconstruction methods have gained popularity over recent years with success reported in the reconstruction of many pathologies, including ankylosis, condylar fracture, neoplasia involving extensive resection, severe inflammatory/degenerative temporomandibular joint (TMJ) disease, and congenital TMJ abnormalities. The authors present a patient who successfully underwent ameloblastoma resection and TMJ reconstruction with a custom TMJ Concepts alloplastic implant. The authors also present a review of the literature on alloplastic TMJ reconstruction following ameloblastoma resection. To our knowledge, this is the second report in the literature on the use of a TMJ Concepts implant after ameloblastoma resection.
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Radiolucent lesion of the posterior mandible in a 47-year-old man. J Am Dent Assoc 2021; 153:184-188. [PMID: 33745681 DOI: 10.1016/j.adaj.2021.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/07/2021] [Accepted: 01/22/2021] [Indexed: 11/23/2022]
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Hresko A, Burtyn O, Pavlovskiy L, Snisarevskyi P, Lapshyna J, Chepurnyi Y, Kopchak A, Karagozoglu KH, Forouzanfar T. Controversies in ameloblastoma management: evaluation of decision making, based on a retrospective analysis. Med Oral Patol Oral Cir Bucal 2021; 26:e181-e186. [PMID: 33037802 PMCID: PMC7980285 DOI: 10.4317/medoral.24104] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/24/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The ameloblastoma management is still challenging to the high recurrence rates and significant morbidity associated with radical treatment. The purpose of this 10-year retrospective study was to analyze the influence of ameloblastoma type and treatment strategy on the long-term outcomes and recurrence rates. MATERIAL AND METHODS The retrospective analyses of 64 histologically-confirmed ameloblastoma cases was performed. The possible risk factors for recurrence and the development of complications were estimated statistically. RESULTS The treatment strategy applied for this group of patients was the following: thirty-four patients (53.1%) were treated conservatively with enucleation or extended bone curettage. Radical treatment (bone resection) was applied in 30 (46.9%) cases. The follow-up period ranged from 2 to 10 years (mean value 4.28 ± 3,26). General recurrence rate consisted 32.8%. This study did not find significant correlations between clinical or histopathological features of the ameloblastoma and the recurrence rate. The only factor that significantly influence recurrence rate was the treatment strategy (41% in conservative treatment vs 15% in radical treatment, p<0.05). Postoperative complications were observed in 42 patients (65.6%) and included face asymmetry and disfigurement (17.2%), temporary paresthesia of the inferior alveolar nerve (IAN) - 23.4%, permanent paresthesia of IAN - 20.3%, paresis of a marginal branch of the facial nerve - 6.3%, infection 12.5%, and swelling - 20.3%. The complication rates, esthetic and functional deficiency were significantly higher in radically treated patients (p<0.05) Conclusions: Our study confirms that higher recurrence rate is associated with conservative treatment for ameloblastoma, while radical treatment leads to an increased number of postoperative complications that affect the patient's quality of life.
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Affiliation(s)
- A Hresko
- Centre of maxillo-facial surgery and dentistry Kyiv regional clinical hospital Sholudenka street, 1A, ap 45. 04116, Kyiv, Ukraine
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Bi L, Wei D, Hong D, Wang J, Qian K, Wang H, Zhu H. A Retrospective Study of 158 Cases on the Risk Factors for Recurrence in Ameloblastoma. Int J Med Sci 2021; 18:3326-3332. [PMID: 34400902 PMCID: PMC8364459 DOI: 10.7150/ijms.61500] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/19/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Ameloblastoma is an odontogenic tumor occurring in jaws, with local aggressiveness and postoperative recurrence. This study was aim to investigate the clinical and radiographic risk factors for recurrence in ameloblastoma. Methods: Patients diagnosed with ameloblastoma between March 2009 and March 2019 were retrospectively analyzed. Clinical and Radiological data and follow-up records were collected. Survival analyses were performed by Kaplan-Meier and log-rank tests, as well as Cox proportional hazards model. Results: One hundred and fifty-eight patients (104 males and 54 females were enrolled. The overall recurrence rate for ameloblastoma was 13.29%, and 10.76% recurred within 5 years. Most of the tumors were located in mandible (86.71%), while the rest 21 cases were in maxilla (13.29%). More than half cases (55.06%) showed multilocular radiolucency, 61 cases (38.61%) showed unilocular radiolucency. Significant differences were found with amelobastoma recurrence rate related to treatment modality, impacted tooth and root resorption (P =0.002, 0.022 and 0.007 respectively). Conclusions: Treatment modality, impacted tooth and root resorption all showed statistically significant associations with the recurrence rate in ameloblastoma. However, due to the limitation of this study, further studies are needed to reveal the true mechanism of ameloblastoma recurrence.
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Affiliation(s)
- Ling Bi
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, 310003,China
| | - Dong Wei
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, 310003,China
| | - Dongsheng Hong
- Key Laboratory for Drug Evaluation and Clinical Research of Zhejiang Province, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003,China
| | - Jin Wang
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, 310003,China
| | - Kejia Qian
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, 310003,China
| | - Huiming Wang
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, 310003,China.,The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Huiyong Zhu
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, 310003,China
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Awadalkreem F, Abdoun O. Enucleation and surgical stent as a treatment strategy for a large unicystic ameloblastoma: Case report and review of literature. Int J Surg Case Rep 2020; 77:371-377. [PMID: 33217656 PMCID: PMC7683291 DOI: 10.1016/j.ijscr.2020.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 11/19/2022] Open
Abstract
Ameloblastoma has a locally invasive and aggressive nature and high recurrence rate. A conservative approach and a radical resection approach have been suggested. Radical resection may lead to esthetic, functional, and psychological sequelae. First use of surgical stent with conservative management for ameloblastoma.
Introduction Ameloblastoma is a benign neoplasm of odontogenic origin with local invasive characteristics and a high recurrence rate. It compromised 1% of the jaw's cysts and tumors with only 10–15% in children. Presentation of case A 14-year-old boy sought treatment for a painless swelling involving the right side of the face started one year ago. The intra-oral examination displayed a firm mass associated with 46, 47 teeth, and the angle of the mandible. The radiographic examination revealed a large well-defined homogeneous radiolucency extending from the 46 region to involve the angle and extending towards the coronoid and condylar processes. An incisional biopsy confirmed the diagnosis of unicystic ameloblastoma. Treatment was planned according to the patient’s age: Phase I: Surgical enucleation. Phase II: Construction and insertion of a surgical stent. Phase III: Construction of a transitional acrylic Kennedy class II partial denture. Phase IV: the patient is scheduled for a definitive implant-supported prosthesis at 18 years old. Discussion The management of ameloblastoma is influenced by the age of the patient, the extension, duration, and position of the lesion, and the histopathological variants. Several authors recommended enucleation as a conservative treatment approach to eliminate the esthetical, functional, and psychological squeals associated with the radical approach. The use of a surgical stent protects the enucleated cavity and promote tissue healing. Conclusion Enucleation and subsequent surgical stent not only eliminates the disease, but also preserves the bone structure, prevents the facial disfigurement, and significantly improve the patient’s esthetic, mastication, oral health, and quality of life.
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Affiliation(s)
- Fadia Awadalkreem
- Department of Oral Rehabilitation, Prosthodontics Division, Faculty of Dentistry, University of Khartoum, Sudan.
| | - Omer Abdoun
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, University of Khartoum, Sudan.
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NAIR M, SHETTY V, AJİLA V, HEGDE S. Ön mandibula'nın tekrarlayan ameloblastomu. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.684312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Morlandt AB, Moore LS, Johnson AO, Smith CM, Stevens TM, Warram JM, MacDougall M, Rosenthal EL, Amm HM. Fluorescently Labeled Cetuximab-IRDye800 for Guided Surgical Excision of Ameloblastoma: A Proof of Principle Study. J Oral Maxillofac Surg 2020; 78:1736-1747. [PMID: 32554066 DOI: 10.1016/j.joms.2020.05.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE Fluorescently labeled epidermal growth factor receptor (EGFR) antibodies have successfully identified microscopic tumors in multiple in vivo models of human cancers with limited toxicity. The present study sought to demonstrate the ability of fluorescently labeled anti-EGFR, cetuximab-IRDye800, to localize to ameloblastoma (AB) tumor cells in vitro and in vivo. MATERIAL AND METHODS EGFR expression in AB cells was confirmed by quantitative real-time polymerase chain reaction and immunohistochemistry. Primary AB cells were labeled in vitro with cetuximab-IRDye800 or nonspecific IgG-IRDye800. An in vivo patient-derived xenograft (PDX) model of AB was developed. The tumor tissue from 3 patients was implanted subcutaneously into immunocompromised mice. The mice received an intravenous injection of cetuximab-IRDye800 or IgG-IRDye800 and underwent imaging to detect infrared fluorescence using a Pearl imaging system (LI-COR Biosciences, Lincoln, NE). After resection of the overlying skin, the tumor/background ratios (TBRs) were calculated and statistically analyzed using a paired t test. RESULTS EGFR expression was seen in all AB samples. Tumor-specific labeling was achieved, as evidenced by a positive fluorescence signal from cetuximab-IRDye800 binding to AB cells, with little staining seen in the negative controls treated with IgG-IRDye800. In the animal PDX model, imaging revealed that the TBRs produced by cetuximab were significantly greater than those produced by IgG on days 7 to 14 for AB-20 tumors. After skin flap removal to simulate a preresection state, the TBRs increased with cetuximab and were significantly greater than the TBRs with the IgG control for PDX tumors derived from the 3 patients with AB. The excised tissues were embedded in paraffin and examined to confirm the presence of tumor. CONCLUSIONS Fluorescently labeled anti-EGFR demonstrated specificity for AB cells and PDX tumors. The present study is the first report of tumor-specific, antibody-based imaging of odontogenic tumors, of which AB is one of the most clinically aggressive. We expect this technology will ultimately assist surgeons treating AB by helping to accurately assess the tumor margins during surgery, leading to improved long-term local tumor control and less surgical morbidity.
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Affiliation(s)
- Anthony B Morlandt
- Associate Professor and Section Chief, Division of Oral Oncology, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Lindsay S Moore
- Resident, Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Aubrey O Johnson
- Student, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Caris M Smith
- Researcher II, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Todd M Stevens
- Associate Professor, Department of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - Jason M Warram
- Associate Professor, Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Mary MacDougall
- Dean and Professor, Faculty of Dentistry, The University of British Columbia, Vancouver, BC, Canada
| | - Eben L Rosenthal
- Professor, Division of Otolaryngology - Head and Neck Surgery, and Associate Director, Department of Clinical Care, Stanford Cancer Institute, Stanford University, Stanford, CA
| | - Hope M Amm
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL.
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Hakeem A, Fitzpatrick SG, Gonsalves CA, Isom J, Islam MN, Bhattacharyya I, Cohen DM, Drew PA. p16INK4a as a proliferation marker unrelated to HPV expression in odontogenic cysts and tumors. J Oral Pathol Med 2019; 49:72-81. [PMID: 31680334 DOI: 10.1111/jop.12972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/24/2019] [Accepted: 10/27/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION p16INK4a is a tumor suppressor protein that retards cell cycle progression from G1 to S phase. Prior studies have evaluated p16INK4a expression in odontogenic keratocyst and ameloblastoma, but data regarding other odontogenic cysts and tumors have been sparse. METHODS With IRB approval, cases from the following entities were identified from archives of the UF Oral Pathology Biopsy Service (2005-2015): benign incidental odontogenic rest, dentigerous cyst, lateral periodontal cyst, calcifying odontogenic cyst, glandular odontogenic cyst, odontogenic keratocyst, orthokeratinized odontogenic cyst, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, and ameloblastoma. All cases were submitted for p16INK4a immunohistochemical testing. RESULTS Results were scored as follows: nuclear and cytoplasmic staining of <5% cells (score 0), 5%-25% (score 1), 25%-50% (score 2), >50% (score 3). No significant difference in p16INK4a staining was noted between odontogenic cysts and the listed odontogenic tumors (chi-square, P = .540). When comparing lesions with higher recurrence rates (over 25% as reported in the literature) versus lesions with low recurrence rates (under 25%), higher recurrence correlated to significantly higher p16INK4a positivity (chi-square, P = .001). Follow-up testing was performed on 18 cases with "2" or "3" p16INK4a expression scores for high-risk HPV strains through HPV in situ hybridization (ISH) messenger RNA testing with no cases exhibiting a positive result. CONCLUSION This study exhibits an association between increased p16INK4a positivity and odontogenic lesions with higher recurrence rates and highlights the role of p16INK4a as a progression marker unrelated to HPV expression in this group of pathologic entities.
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Affiliation(s)
- Abdulaziz Hakeem
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Sarah G Fitzpatrick
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Catherine A Gonsalves
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - James Isom
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Mohammed N Islam
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Indraneel Bhattacharyya
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Donald M Cohen
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Peter A Drew
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
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Mohammed Asif S, Mohammed Kaleem S, Mohammed Al Mubarak H, Shariff M, Sandeepa NC. Negligence or tumor aggressiveness: A case report of recurrent ameloblastoma. SAGE Open Med Case Rep 2019; 7:2050313X19834416. [PMID: 30886719 PMCID: PMC6410386 DOI: 10.1177/2050313x19834416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 02/05/2019] [Indexed: 11/16/2022] Open
Abstract
Ameloblastomas with multiple histologic variants are rare odontogenic neoplasm of mandible and maxilla, and have high recurrence rates if improperly treated. They are histologically benign, slow growing, and invasive tumors. These tumors are asymptomatic in nature, unless they attain a large size to cause expansion and perforation of adjacent tissues, for which patient might seek treatment. Due to their aggressive nature and high recurrence rate, treatment remains a matter of debate. Complete excision of lesion with least morbidity would be the therapeutic challenge. However, there is an increased risk of recurrence due to local treatment. Here in, we present a large multicystic recurrent ameloblastoma on right-body-ramus region of mandible in a 45-year-old woman who was managed by hemimandibulectomy.
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Affiliation(s)
- Shaik Mohammed Asif
- Department of Diagnostic Sciences and Oral Biology, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Sultan Mohammed Kaleem
- Department of Diagnostic Sciences and Oral Biology, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Hussain Mohammed Al Mubarak
- Department of Diagnostic Sciences and Oral Biology, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Mansoor Shariff
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Nuchlakath Chalikkandy Sandeepa
- Department of Diagnostic Sciences and Oral Biology, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
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Management of large pediatric ameloblastoma: Conservative approach with 4-years follow up. ORAL AND MAXILLOFACIAL SURGERY CASES 2019. [DOI: 10.1016/j.omsc.2018.100093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Ohiro Y, Yamada T, Kakuguchi W, Kobayashi I, Kitamura T, Tei K. Modified “Dredging Method” for complicated solid/multicystic ameloblastoma in the mandible: Report of a case treated by fractionated enucleation. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2019. [DOI: 10.1016/j.ajoms.2018.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pai A, Singhavi H, Mair M, Nair S, Nair D, Chaturvedi P. Surgical excision with the negative margins offers best cure rates for ameloblastoma: A case series and review of literature. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS 2019. [DOI: 10.4103/jhnps.jhnps_1_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Slusarenko da Silva Y, Tartaroti NA, Sendyk DI, Deboni MCZ, Naclério-Homem MDG. Is conservative surgery a better choice for the solid/multicystic ameloblastoma than radical surgery regarding recurrence? A systematic review. Oral Maxillofac Surg 2018; 22:349-356. [PMID: 30191338 DOI: 10.1007/s10006-018-0715-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 08/24/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Determine if conservative surgery of primary solid/multicystic ameloblastoma (SMA) is capable of decreasing the recurrence rate as effectively as radical surgery. METHODS We searched in MEDLINE, Web of Science, Scopus and Cochrane Library for original studies reporting on the conservative or radical treatment of primary SMA and the related recurrence rate. All selected data were independently assessed. Meta-analysis was performed and the Relative Risk (RR) of recurrence with a confidence interval of 95% was the effect measure. P value for the summary effect of < 0.05 was considered statistically significant. RESULTS The 2647 records retrieved were reduced to 7 studies to be qualitatively assessed and 4 studies were included in the meta-analysis. RR of 1.88 [0.59, 5.95] of the pooled values pointed that recurrence rate after the conservative surgery is neither comparable nor lower than the radical surgery (P = 0.28). CONCLUSIONS Conservative surgery does not reduce the recurrence rate as efficiently as radical surgery for primary SMA. However, there is not enough evidence to support this statement.
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Affiliation(s)
- Yuri Slusarenko da Silva
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil.
| | - Natalia Aguiar Tartaroti
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil
| | - Daniel Isaac Sendyk
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil
| | - Maria Cristina Zindel Deboni
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil
| | - Maria da Graça Naclério-Homem
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil
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Sharp RC, Effiom OA, Dhingra A, Odukoya O, Olawuyi A, Arotiba GT, Boesze-Battaglia K, Akintoye SO. Enhanced basal autophagy supports ameloblastoma-derived cell survival and reactivation. Arch Oral Biol 2018; 98:61-67. [PMID: 30465934 DOI: 10.1016/j.archoralbio.2018.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/07/2018] [Accepted: 11/12/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Ameloblastoma is an aggressive odontogenic jaw neoplasm. Its unlimited growth confers high potential for malignant transformation and recurrence. It is unclear why ameloblastoma is highly recurrent despite surgical resection with a wide margin of normal tissue. While canonical autophagy can be used to degrade and eliminate damaged cellular components, it is also a protective mechanism that provides energy and vital metabolites for cell survival. We used ameloblastoma-derived cells to test the hypothesis that autophagic processes play a role in survival and reactivation of ameloblastoma. METHODS Primary epithelial (EP-AMCs) and mesenchymal (MS-AMCs) ameloblastoma-derived cells were established from tissue samples of solid multicystic ameloblastoma. Clonogenic capacity and basal autophagic capacity were assessed in ameloblastoma-derived cells relative to human odontoma-derived cells (HODCs) and maxilla-mesenchymal stem cells (MX-MSCs). Ability of ameloblastoma-derived cells to survive and form new ameloblastoma was assessed in mouse tumor xenografts. RESULTS EP-AMCs were highly clonogenic (p < 0.0001) and demonstrated enhanced basal levels of autophagic proteins microtubule-associated protein 1-light chain 3 (LC3) (p < 0.01), p62 (Sequestosome 1, SQSTM1) (p < 0.01), and the LC3-adapter, melanoregulin (MREG) (p < 0.05) relative to controls. EP-AMCs xenografts regenerated solid ameloblastoma-like tumor with histological features of columnar ameloblast-like cells, loose stellate reticulum-like cells and regions of cystic degeneration characteristic of follicular variant of solid multicystic ameloblastoma. The xenografts also displayed stromal epithelial invaginations strongly reactive to LC3 and p62 suggestive of epithelial-mesenchymal transition and neoplastic odontogenic epithelium. CONCLUSIONS EP-AMCs exhibit altered autophagic processes that can support survival and recurrence of post-surgical ameloblastoma cells.
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Affiliation(s)
- Rachel C Sharp
- Department of Biochemistry, School of Dental Medicine, University of Pennsylvania, Philadelphia PA USA
| | - Olajumoke A Effiom
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos Nigeria
| | - Anuradha Dhingra
- Department of Biochemistry, School of Dental Medicine, University of Pennsylvania, Philadelphia PA USA
| | - Onatolu Odukoya
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos Nigeria
| | - Adetokunbo Olawuyi
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos Nigeria
| | - Godwin T Arotiba
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Lagos, Lagos Nigeria
| | - Kathleen Boesze-Battaglia
- Department of Biochemistry, School of Dental Medicine, University of Pennsylvania, Philadelphia PA USA
| | - Sunday O Akintoye
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia PA USA.
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Isolan CP, Moreira AG, Edges A, Post LK, Aitken-Saavedra JP. Successful conservative treatment of a mandibular unicystic ameloblastoma: 13-year follow-up. J Clin Exp Dent 2018; 10:e1123-e1126. [PMID: 30607231 PMCID: PMC6311408 DOI: 10.4317/jced.54897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 10/15/2018] [Indexed: 12/02/2022] Open
Abstract
Ameloblastoma is an uncommon, locally aggressive benign odontogenic tumor and can reach considerable dimensions causing facial deformity and functional impairment. They are characterized by local aggressiveness. It is recommended that maxillary ameloblastomas be treated aggressively due to proximity of various vital structures. Conservative treatments such as marsupialization, enucleation and curettage while preserving bone integrity seem to be associated with a high rate of recurrence. Treatment evaluation of ameloblastomas is a complex issue, as ideally it should not be so destructive due to the benign nature of this lesion, but should be extensive enough to avoid recurrences. The present study is about a clinical case of a 16-year- old man with a unicystic ameloblastoma treated successfully with marsupialization. Patient was followed up every 12 months. About 13 years after diagnosis, the patient is clinically healthy and radiographically it is possible to observe evidence of bone repair.
Key words:Odontogenic tumors, ameloblastoma, marsupialization, unicystic.
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Affiliation(s)
- Cristina-Pereira Isolan
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil and not Post Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Andressa-Goicochea Moreira
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil and not Post Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Adriana Edges
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil and not Post Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Leticia-Kirst Post
- Department of Surgery and Maxillofacial Traumatology, School of Dentistry, Federal University of Pelotas, Pelotas Brazil
| | - Juan-Pablo Aitken-Saavedra
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil and not Post Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
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Babichenko II, Tsimbalist NS, Rybal'skaya VF, Sherstnev AA, Syomkin VA. [The role of Wnt/β-catenin signaling pathway in ameloblastoma formation]. STOMATOLOGII︠A︡ 2018; 97:22-24. [PMID: 29795099 DOI: 10.17116/stomat201897222-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the study was to assess the role of the canonical Wnt/β-catenin signaling pathway in the formation and clinical course of various histological variants of ameloblastoma. MATERIAL AND METHODS 76 cases of ameloblastoma were investigated, the average age of the patients was 46 years. There were 49 (64.5%) cases of recurrence of the disease. Tissue antigens were determined using monoclonal rabbit antibodies to Ki-67 and β-catenin. RESULTS it was found correlation between the proliferative activity of ameloblastoma cells and the intranuclear localization of β-catenin, indicating the activation of the Wnt/β-catenin-signaling pathway. It was shown that the nuclear localization of β-catenin is positively correlated with the recurrence. CONCLUSION The Wnt/β-catenin signaling pathway is involved in a formation and progression of ameloblastoma.
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Affiliation(s)
- I I Babichenko
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia, 119991
| | - N S Tsimbalist
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia, 119991
| | - V F Rybal'skaya
- Peoples' Friendship University of Russia, Moscow, Russia, 117198
| | - A A Sherstnev
- Peoples' Friendship University of Russia, Moscow, Russia, 117198
| | - V A Syomkin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia, 119991
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Recurrent Ameloblastoma: A Surgical Challenge. Case Rep Dent 2018; 2018:8271205. [PMID: 29682361 PMCID: PMC5841118 DOI: 10.1155/2018/8271205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 01/12/2018] [Accepted: 01/28/2018] [Indexed: 12/02/2022] Open
Abstract
Ameloblastoma is locally aggressive benign odontogenic tumour with increased risk of recurrence rate. The choice of treatment depends on the histologic subtype. Radical therapy is the recommended modality for solid ameloblastomas. The possibilities of recurrence even after enbloc resection are still high. The author presents two case reports of recurrent ameloblastomas postradical resection. First case describes the recurrence of ameloblastoma in the bone graft which was used for reconstruction, and the second case depicts recurrence in the infratemporal fossa. Intraoperative radiography of the frozen section of the soft tissue margin plays an important role in the holistic management of these lesions.
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Incidental ameloblastoma diagnosed after treatment for childhood tumor. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2017. [DOI: 10.1016/j.epsc.2017.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Yusa K, Yamanochi H, Takagi A, Iino M. Three-Dimensional Printing Model as a Tool to Assist in Surgery for Large Mandibular Tumour: a Case Report. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2017; 8:e4. [PMID: 28791080 PMCID: PMC5541989 DOI: 10.5037/jomr.2017.8204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 06/24/2017] [Indexed: 01/17/2023]
Abstract
Objectives Recently, three-dimensional printing models based on preoperative computed tomography and magnetic resonance imaging images have been widely used in medical fields. This study presents an effective use of the three-dimensional printing model in exploring complex spatial relationship between the tumour and surrounding tissue and in simulation surgery based planning of the operative procedure. Material and Methods The patient was a 7-year-old boy with ameloblastic fibro-odontoma. Prior to surgery, a hybrid three-dimensional printing model consisting of the jaw bone, the tumour and the inferior alveolar nerve was fabricated. After the simulation surgery based on this model, enucleation of the tumour, leaving tooth 46 intact (Universal Numbering System by ADA) safe, was planned. Results Enucleation of the tumour was successfully carried out. One year later, healing was found to be satisfactory both clinically and radiographically. Conclusions The study presented an effective application of a novel hybrid three-dimensional printing model composed of hard and soft tissues. Such innovations can bring significant benefits, especially to the field of oncological surgery.
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Affiliation(s)
- Kazuyuki Yusa
- Department of Dentistry, Oral and Maxillofacial - Plastic and Reconstructive Surgery Faculty of Medicine, Yamagata University, YamagataJapan
| | - Hideyuki Yamanochi
- Department of Dentistry and Oral Surgery, Shinjo Tokushukai Hospital, Yamagata, Japan
| | - Akira Takagi
- Department of Dentistry, Oral and Maxillofacial - Plastic and Reconstructive Surgery Faculty of Medicine, Yamagata University, YamagataJapan
| | - Mitsuyoshi Iino
- Department of Dentistry, Oral and Maxillofacial - Plastic and Reconstructive Surgery Faculty of Medicine, Yamagata University, YamagataJapan
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