Ameloblastoma natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Natural History
Ameloblastoma is a rare disorder of the jaw involving abnormal tissue growth. The resulting tumors or cysts are usually not malignant (benign) but the tissue growth may be aggressive in the involved area. On occasion, tissue near the jaws, such as around the sinuses and eye sockets, may become involved as well. The tissues involved are most often those that give rise to the teeth so that ameloblastoma may cause facial distortion. Malignancy is uncommon as are metastases, but they do occur. Ameloblastoma is characterized by an abnormal growth in the sinus area or jaw, often at the site of the third molar. The tumors or cysts may be aggressive and may spread to the nose, eye socket and skull. It is important for ameloblastoma to be diagnosed and treated early in order to stop growth of the tumors and possible progression to cancer. Although it is uncommon, ameloblastomas have been known to become malignant and spread to other parts of the body, especially to the lungs. The initial surgical treatment must be carefully and scrupulously done to avoid recurrence.
Ameloblastomas do not usually become malignant. There is evidence that tissue is more likely to become malignant if the condition reoccurs after surgery. Ameoloblastomas tend to be treated by surgical en-bloc resection. Local curettage is associated with a high rate of local recurrence (45-90%).
Simple unicystic lesions are less common but have a better prognosis. Simple (no nodule) variant will not be diagnosable on radiography, as it will be indistinguishable form other more common cysts. Luminal variant, has a single nodule projecting into the cyst. Mural variant has multiple nodules (often only microscopic) in the wall of the cyst. The latter has an elevated risk of recurrence. Generally, complete surgical excision with wide surgical margins result in a good prognosis for Ameloblastoma The tissue growth may be removed, but newer growths could be a frequent occurrence
Complications
According to World Health Organization (WHO) ameloblastoma is a benign tumor. Metastases to the lungs or central nervous system (CNS) have rarely been reported. Complications of ameloblastoma include the following:
- Breathing difficulty
- Pain and facial deformity
- Secondary infection of the tumor
- The recurrence rate of these tumors is 25-30%. The tumor can recur after treatment and hence, a close follow-up is needed.