CASE REPORT

Aggressiveness tumor: a case report of recurrent ameloblastoma in the mandible

Marjono Dwi Wibowo , Agung Fuad Fathurochman

Marjono Dwi Wibowo
Department of Surgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia.. Email: [email protected]

Agung Fuad Fathurochman
Resident of Surgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia.
Online First: April 28, 2021 | Cite this Article
Wibowo, M., Fathurochman, A. 2021. Aggressiveness tumor: a case report of recurrent ameloblastoma in the mandible. Bali Medical Journal 10(1): 184-188. DOI:10.15562/bmj.v10i1.2114


Background: Ameloblastomas are rare odontogenic neoplasms of the mandible and maxilla. They have high recurrence rates if improperly treated. Due to their aggressive nature and high recurrence rate, treatment remains a matter of debate. Complete excision of the lesion with the least morbidity would be the therapeutic challenge.

Case Report: A 67 years old woman complained of swelling on her left jaw four years ago, the jaw was small swelling initially, and then it has grown to the size of a tennis ball. She had a history of similar swelling on the same site 12 years back for which she was operated on (enucleation). On physical examination, there is a mass in the left mandibular bone above the surgical wound, hard, painless and motionless, with a size of 18 cm x 11 cm x 11 cm. Plain x-ray examination showed multiple cystic lesions in the left mandible. In this case, segmental mandibular resection was performed, followed by reconstruction using a K-wire.

Discussion: Many treatment options range from conservative treatment of curettage, enucleation to radical surgical approaches of wide margin excision. Radical treatment approaches have the advantage of lowering the recurrence rates but at the same time pose extremely difficult challenges of reconstruction of the surgical defects.

Conclusion: Ameloblastoma has high recurrence rate if it is not treated properly. At least 1 cm of healthy bone should be removed during surgical procedure beyond panoramic radiograph visible margins. In our patient, though radical surgery eliminated a large possibility of recurrence.

References

McClary AC, West RB, McClary AC, Pollack JR, Fischbein NJ, Holsinger CF, et al. Ameloblastoma: a clinical review and trends in management. Eur Arch Oto-Rhino-Laryngology. 2016;273(7):1649–61.

Montoro JR de MC, Tavares MG, Melo DH, Franco R de L, Mello-Filho FV de, Xavier SP, et al. Mandibular ameloblastoma treated by bone resection and imediate reconstruction. Rev Bras Otorrinolaringol. 2008;74(1):155–7.

Vohra FA, Hussain M, Mudassir MS. Ameloblastomas and their management: A review. J Surg Pak. 2009;14(3):136–42.

Singh M, Shah A, Bhattacharya A, Raman R, Ranganatha N, Prakash P. Treatment algorithm for ameloblastoma. Case Rep Dent. 2014;2014.

Dandriyal R, Gupta A, Pant S, Baweja HH. Surgical management of ameloblastoma: Conservative or radical approach. Natl J Maxillofac Surg. 2011;2(1):22.

Dunn JL, Olan WJ, Bank WO, Narang AK, Schwartz AM. Giant ameloblastoma: radiologic diagnosis and treatment. Radiographics. 1997;17(2):531–6.

Goldman KE. Mandibular Cysts and Odontogenic Tumors: Overview, Odontogenic Mandibular Cysts, Nonodontogenic Mandibular Cysts [Internet]. 2019. Available from: https://emedicine.medscape.com/article/852734-overview


No Supplementary Material available for this article.
Article Views      : 0
PDF Downloads : 0