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Ameloblastoma

Case contributed by James Sheldon
Diagnosis certain

Presentation

Left jaw swelling. Painless.

Patient Data

Age: 50 years
Gender: Male

OPG

x-ray

OPG and CT demonstrate focal bony expansile destructive lesion in the left hemimandible

ct

CT demonstrates focal bony expansile destructive lesion in the left hemimandible

OPG

x-ray

Status post left segmental mandibulectomy and plate reconstruction.

Case Discussion

Ameloblastomas are benign, locally aggressive tumors that arise from the mandible, or less commonly from the maxilla.

Ameloblastomas are the second most common odontogenic tumor (odontoma is the most common) and account for up to a 3rd of such cases.

They are slow growing and tend to present in the 3rd to 5th decades of life, with no gender predilection.

Ameloblastomas typically occur as hard painless lesions near the angle of the mandible in the region of the 3rd molar tooth (48 and 38) although they can occur anywere along the alveolus of the mandible (80%) and maxilla (20%). When the maxilla is involved, the tumor is located in the premolar region, and can extend up in the maxillary sinus.

Although benign, it is a locally aggressive neoplasm with a high rate of recurrence. Approximately 20% of cases are associated with dentigerous cysts and unerrupted teeth.

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