Plexiform ameloblastoma

Histopathological patterns and biological characteristics of ameloblastoma: A retrospective cross-sectional study

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.

Tomoelastography for non-invasive detection of ameloblastoma and metastatic neck lymph nodes

Ameloblastoma is a benign epithelial tumour and the most common odontogenic tumour, accounting for about 18% of cases. We present a patient to illustrate the first use of tomoelastography for quantitatively mapping tissue stiffness (shear wave speed) and fluidity (loss angle of the complex shear modulus) in a metastasised ameloblastoma of the left mandible. Tomoelastography maps clearly depicted the extent of the tumour by abnormally high values of stiffness and fluidity (1.73±0.23 m/s, 1.18±0.08 rad) compared with normal values in the contralateral mandible (1.04±0.09 m/s, 0.93±0.12 rad). Abnormal stiffness also revealed metastatic involvement of the neck lymph nodes (1.30±0.03 m/s vs 0.86±0.01 m/s). Taken together, stiffness and fluidity measured by tomoelastography can sensitively detect the presence and extent of bone tumours and metastatic spread to cervical lymph nodes.

Pediatric odontogenic tumor of the jaw - a case report

Central jaw tumors (intra osseous) in children occur infrequently and few oral pathologists have had the opportunity or experience in diagnosing these lesions and predicting their biological behavior. Some children are not diagnosed correctly at the initial stages as having a neoplasm and are wrongly treated for infections by antibiotic administration. Subsequent to an unresponsive antibiotic therapy radiographs are taken to reveal a radiolucent or radio dense lesion in the jaws. Finally a tissue diagnosis becomes necessary in order to diagnose and initiate proper therapy. One among the central jaw tumors that occur infrequently in children is Ameloblastoma. It is often aggressive and destructive, with the capacity to attain great size, erode bone and invade adjacent structures. Ameloblastoma not only accounts for 1% of all tumors of maxilla and mandible but also 11% of all odontogenic tumors. It has a high percentage of local recurrence rate and possible malignant development when treated inadequately. Here we present a central jaw tumor in an 8-year-old child which was a case of unusually large plexiform ameloblastoma involving entire ramus up to the condyle, and part of body of the mandible.