Ameloblastoma: Difference between revisions

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{{CMG}}
{{CMG}}


{{SK}} Jaw neoplasms; benign neoplasm of the lower jaw
{{SK}} Jaw neoplasms; neoplasm of the lower jaw


==Overview==
==[[Ameloblastoma overview|Overview]]==


==[[Ameloblastoma historical perspective|Historical Perspective]]==


==Subtypes==
==[[Ameloblastoma classification|Classification]]==
There are three main clinical subtypes of ameloblastoma: unicystic, multicystic, peripheral. A fourth subtype, malignant, has been considered by some oncologic specialists, however, this form of the tumor is rare and may be simply a manifestation of one of the three main subtypes.


==Clinical features==
==[[Ameloblastoma pathophysiology|Pathophysiology]]==
Ameloblastomas are often associated with the presence of unerupted [[teeth]]. Symptoms include painless swelling, facial deformity if severe enough, pain if the swelling impinges on other structures, loose teeth, ulcers, and periodontal (gum) disease.Lesions will occur in the mandible and maxilla,although 75% occur in the ascending ramus area and will result in extensive and grotesque deformitites of the mandible and maxilla.In the maxilla it can extend into the maxillary sinus and floor of the nose.The lesion has a tendency to expand the bony cortices because slow growth rate of the lesion allows time for periosteum to develop thin shell of bone ahead of the expanding lesion.This shell of bone cracks when palpated and this phenomenon is referred to as "Egg Shell Cracking",an important diagnostic feature. Ameloblastoma is tentatively diagnosed through [[radiograph]]ic examination and must be confirmed by histological examination (e.g., [[biopsy]]).  Radiographically, it appears as a lucency in the bone of varying size and features--sometimes it is a single, well-demarcated lesion whereas it often demonstrates as a multiloculated "soap bubble" appearance.  Resorption of roots of involved teeth can be seen in some cases, but is not unique to ameloblastoma.  The disease is most often found in the posterior body and angle of the mandible, but can occur anywhere in either the maxilla or mandible.


Ameloblastoma is often associated with bony-impacted wisdom teeth--one of the many reasons dentists recommend having them extracted.
==[[Ameloblastoma causes|Causes]]==


==[[Ameloblastoma differential diagnosis|Differentiating Ameloblastoma from other Diseases]]==


==[[Ameloblastoma risk factors|Risk Factors]]==


==Histopathology==
==[[Ameloblastoma natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
Histopathology will show cells that have the tendency to move the nucleus away from the basement membrane.This process is referred to as "Reverse Polarization".The follicular type will have outer arrangement of columnar or palisaded ameloblast like cells and inner zone of triangular shaped cells resembling stellate reticulum in bell stage.The central cells sometimes degenerate to form central microcysts.The plexiform type has epithelium that proliferates in a "Fish Net Pattern".


==Variants==
==Diagnosis==
Desmoplastic Ameloblastoma,
[[Ameloblastoma history and symptoms|History and Symptoms]] | [[Ameloblastoma physical examination|Physical examination]] | [[Ameloblastoma laboratory findings|Laboratory Findings]] | [[Ameloblastoma x ray|X ray]] | [[Ameloblastoma CT|CT]] | [[Ameloblastoma MRI|MRI]] | [[Ameloblastoma ultrasound|Ultrasound]] | [[Ameloblastoma other imaging findings|Other Imaging Findings]] | [[Ameloblastoma other diagnostic studies|Other Diagnostic Studies]]
Granular Cell variant,
Basal Cell variant,


==Treatment==
==Treatment==
Ameloblastomas are relatively resistant to [[chemotherapy]] or [[radiation therapy]], thus, [[surgery]] is the most common treatment of this tumor. Because of the invasive nature of the growth, excision of normal tissue near the tumor margin is often required.  Some have likened the disease to basal cell carcinoma (a skin cancer) in its tendency to spread to adjacent bony and sometimes soft tissues without metastasizing.  While not a cancer that actually invades adjacent tissues, ameloblastoma is suspected to spread to adjacent areas of the jaw bone via marrow space.  Thus, treatment of the disease is very much like surgical treatment of cancer.  Wide margins that are clear of disease are required for a good prognosis.  Often, treatment requires excision of entire portions of the jaw.  Recurrence is common.
[[Ameloblastoma medical therapy|Medical Therapy]] | [[Ameloblastoma surgery|Surgery]] | [[Ameloblastoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Ameloblastoma future or investigational therapies|Future or Investigational Therapies]]


==Support link==
==Case Studies==
[http://survivor-support.rare-cancer.org/forum/groupcp.php?g=1514 Adult Rare Brain Tumors]
[[Ameloblastoma case study one|Case #1]]




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{{Soft tissue tumors and sarcomas}}
{{Soft tissue tumors and sarcomas}}


[[Category:Disease]]
[[Category:Oral pathology]]
[[Category:Oral pathology]]
[[Category:Oncology]]
[[Category:Oncology]]

Revision as of 19:33, 11 September 2012

Ameloblastoma
ICD-10 D16.5
ICD-9 213.1
ICD-O: 9310/0
DiseasesDB 31676
MeSH D000564

Ameloblastoma Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Jaw neoplasms; neoplasm of the lower jaw

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Ameloblastoma from other Diseases

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical examination | Laboratory Findings | X ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1


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