Clinical and histological types of ameloblastoma
Vasiliki KARATHANASI, Nikolaos NIKITAKIS, Konstantinos TOSIOS, Alexandra SKLAVOUNOU
Department of Oral Pathology & Medicine, Dental School, University of Athens, Greece (Head: Professor A. Sklavounou)
Hellenic Archives of Oral & Maxillofacial Surgery (2010) 2, 91-104
SUMMARY: Ameloblastoma is one of the most frequent epithelial odontogenic tumors, with great clinical significance, mainly due to its local invasive ability. It is a benign lesion and only rarely demonstrates a malignant biological behavior. This study aims at the analytical description of the various clinical and histological varieties of ameloblastoma, as well as at the review of the recent international lite - rature, regarding the origin, classification, biological behavior and treatment of ameloblastoma. Conventional ameloblastoma, mainly developing in the posterior region of the mandible, is the most frequent clinicopathological type, while the unicystic and peripheral ameloblastomas are less common. Among the histological subtypes of the lesion, the follicular is the most common, while increased aggressive biological behavior is attributed to the desmoplastic type. The malignant varieties of ameloblastoma comprise only 1% of the total cases. Currently, it is supported that the development and progression of odontogenic tumors is caused by gene - tic and molecular alterations. Thus, further studies are required in order to clarify the pathogenesis of the odontogenic tumors and to develop new treatment modalities, such as targeted molecular treatment, as alternatives or supplementary to the available surgical methods.
KEY WORDS: Οdontogenic tumor, ameloblastoma, cli ni cal and histological types, pathogenesis.
REFERENCES
Aγγελόπουλος ΑΠ, Παπανικολάου Σ, Αγγελοπούλου Ε: Οδοντογενείς όγκοι. Μοντέρνα Στοματική και Γναθοπροσωπική Παθογογία, 3η Εκ. Λίτσας 2000, σελ 457-484
Abiko Y, Nagayasu H, Takeshima M, Yamazaki M, Nishimura M, Kusano K, Kitajo H, Saitoh M, Kawakami T, Chiba I, Kaku T: Ameloblastic carcinoma ex ameloblastoma: report of a casepossible involvement of CpG island hypermethylation of the p16 gene in malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:72-76, 2007
Ackermann GL, Altini M, Shear M: The unicystic ameloblastoma: a clinicopathologic study of 57 cases. J Oral Pathol 17:541-546, 1988
Andresakis D, Valsamis S, Rapidis A: Current views in the surgical treatment of jaw ameloblastomas. Hellenic Stomatologikal Re - view 49:93-107, 2005 Barnes L, Eveson JW, Reichart P, Sidransky D: Odontogenic tumors, In: World Health Organization classification of tumors: pathology and genetics of head and neck tumors. IARC Press 2005, pp.283-327
Beckley ML, Farhood V, Helfend LK, Alijanian A: Desmoplastic ameloblastomas of the mandible: A case report and review of literature. J Oral Maxillofac Surg 60:194-198, 2002
Bredenkamp JK, Zimmerman MC, Mickel RA: Maxillary ameloblastoma. A potentially lethan neoplasm. Arch Otolaryngol Head Neck Surg 115:99-104, 1989 Buchner A, Sciubba JJ: Peripheral epithelial odontogenic tumors: a review. Oral Surg 63:688-697, 1987
Eleftheriadis E, Sklavounos A, Sotiriadou S, Pittara D, Trigonidis G: Mural ameloblastoma of the maxilla. Case report. Greec J Oral Maxillofac Surg 9:59-63, 1994
Eversole LR, Leider AS, Hansen LS: Ameloblastomas with pronounced desmoplasia. J Oral Maxillofac Surg 42:735-40, 1984
Gardner DG: Some current concepts on the pathology of ameloblastomas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 82:660-669, 1996
Goldblatt LI, Brannon RB, Ellis GL: Squamous odontogenic tumor, report of five cases and review of the literature. Oral Surg Oral Med Oral Pathol 54:187-196, 1982
Ide F, Kusama K, Tanaka A, Sakashita H: Peripheral ameloblastoma is not a hamartoma but rather more of a neoplasm. Oral Oncol 38:318-320, 2002
Ide F, Kusama K: Difficulty in predicting biological behaviour of peripheral ameloblastoma. Oral Oncol 40:651-652, 2004
Kawano K, Mizuki H, Yanagisawa S: Peripheral ameloblastoma exhi - biting an invasion of the alveolar bone: report of a case. J Jap Soc Oral Tum 4:88-92, 1992
Kramer IRH, Pindborg JJ, Shear M. Histological typing of odontogenic tumors. 2nd edition Springer-Verlag Berlin: 1992, pp. 11-25
Kumamoto H, Ooya K: Immunohistochemical detection of retinobla - stoma protein and E2 promoter-binding factor-1 in ameloblastomas. J Oral Pathol Med. 35:183-189, 2006
Kuru H: Ueber das adamantinom. Centralbl f allg path u path anato - mie (iena) 22:291, 1911
Lam KY, Chan ACL, Wu PC, Chau KY, Tideman H, Wei W: Desmo - plastic variant of ameloblastoma in Chinese patients. Br J Oral Maxillofac Surg 36:129-134, 1998
Leider AS, Eversole LR, Barkin ME: Cystic ameloblastoma. Oral Surg Oral Med Oral Pathol 60:624-630, 1985
Li TJ, Browne RM, Matthews JB: Expression of proliferating cell nuclear antigen (PCNA) and Ki-67 in unicystic ameloblastoma. Histopathology 26:219-228, 1995
Martelli-Junior H, Souza L, Santos L, Melo-Filho MR, De Paula AM: Peripheral ameloblastoma: a case report. Oral Surg Oral Med Oral Path Oral Radiol Endod 99:E31-3, 2005
Mendenhall WM, Werning JW, Fernandes R, Malyapa RS, Mendenhall NP: Ameloblastoma. Am J Clin Oncol 30:645-648, 2007
Muller H, Slootweg PG: The Ameloblastoma, the controversial approach to therapy. J Maxillofac Surg 13:79-84, 1985 Nakamura N, Higuchi Y, Mitsuyasu T, Santra F, Ohishi M: Compa - rison of long-term results between different approaches to ame - loblastoma. Oral Surg 93:13-20, 2002
Namin AK, Azad TM, Eslami B, Sarkarat F, Shahrokhi M, Kashanian F: A study of the relationship between ameloblastoma and human papiloma virus. J Oral Maxillofac Surg 61:467-470, 2003
Neville BW, Damma DD, Allen CM, Bouquot JE: Tumors of odontogenic epithelium-Ameloblastoma, In: Neville BW, Damma DD, Allen CM, Bouquot JE: Oral and Maxillofacial Pathology, 3rd edition WB Saunders, Philadelphia: 2009, pp.702-712
Ng KH, Siar CH: Peripheral ameloblastoma with clear cell differentiation. Oral Surg Oral Med Oral Pathol 70:210-213, 1990
Ord RA, Blanchaert RH, Nikitakis NG, Sauk JJ: Ameloblastoma in children. J Oral Maxillofac Surg 60:762-770, 2002
Pekiner FH, Ozbayrak S, Sener BC, Olgaç V, Sinanoğlu A: Peripheral ameloblastoma: a case report. Dentomaxillofac Radiol 36:183- 186, 2007
Philipsen HP, Ormiston IW, Reichart PA: The desmo- and osteoplastic ameloblastoma. Histologic variant or clinicopathologic entity? Case reports. Int J Oral Maxillofac Surg 21:352-357, 1992
Philipsen HP, Reichart PA: Unicystic ameloblastoma. A review of 193 cases from the literature. Oral Oncol. 34:317-325, 1998
Philipsen HP, Reichart PA, Takata T: Desmoplastic ameloblastoma (including “hybrid” lesion of ameloblastoma). Biological profile based on 100 cases from the literature and own files. Oral Oncol 37:455-460, 2001α
Philipsen HP, Reichart PA, Nikai H, Takata T, Kudo Y: Peripheral ameloblastoma: biological profile based on 160 cases from the literature. Oral Oncol 37:17-27, 2001β
Reichart PA, Philipsen HP, Sonner S: Ameloblastoma: biological profile of 3677 cases. Eur J Cancer B Oral Oncol 31B:86-99, 1995
Sampson DE, Pogrel MA: Management of mandibular ameloblastoma: The clinical basis for the treatment algorithm. J Oral Maxillofac Surg 57:1074-1077, 1999
Sehdev MK, Huvos AG, Strong EW, Gerold FP, Willis GW: Ameloblastoma of maxilla and mandible. Cancer 33: 324-333, 1974
Shashikanth MC, Neetha MC, Ali IM, Shambulingappa P: Desmo - plastic ameloblastoma in the maxilla: A case report and review of literature. Indian J Dent Res 18:214-217, 2007 Shetty K: Peripheral ameloblastoma: an etiology from surface epithelium? Case report and review of literature. Oral Oncol Extra 41:211-215, 2005
Takamori M, Yamada Y, Honda K: A case of peripheral ameloblastoma. J Tokyo Med Univ 52:752-757, 1994 T
akigawa T, Matsumoto M, Sekine Y, et al: A case report of amelo - blastoma proliferated like epulis of maxilla. Nihon Univ Dent J 55:920-924, 1981
Tilaveridis I, Dimitrakopoulos I, Lazaridis N: The contribution of marsupialization in the treatment of unicystic ameloblastomas of the mandible. Clinical study. Greec J Oral Maxillofac Surg 13: 119- 123, 1998
Τσιχλάκης Κ, Στεφάνου Ε: Διαφορική διάγνωση οστικών όγκων. Στο: Aγγελόπουλος ΑΠ, Σπυρόπουλος ΝΔ, Τσιχλάκης Κ: Μοντέρνα Στοματική και Γναθοπροσωπική Διάγνωση και Ακτινολογία, 3η Εκ. Λίτσας 2001, σελ 479-481
Vanoven BJ, Parker NP, Petruzzelli GJ: Peripheral ameloblastoma of the maxilla: a case report and literature review. Am J Oto - laryncology 29:357-360, 2008 Vered M, Shohat I, Buchner A: Epidermal growth factor receptor expression in ameloblastoma. Oral Oncol. 39:138-143, 2003
Waldron CA, el-Mofty SK: A histopathologic study of 116 ameloblastomas with special reference to the desmoplastic variant. Oral Surg Oral Med Oral Pathol 63:441-451, 1987
Wettan HL, Patella PA, Freedman PD: Peripheral ameloblastoma: review of the literature and report of recurrence as severe dysplasia. J Oral Maxillofac Surg 59:811-815, 2001
Zhu EX, Okada N, Takagi M: Peripheral ameloblastoma: case report and review of literature. J Oral Maxillofac Surg 53:590-594, 1995
Zwahlen RA, Gratz KW: Maxillary ameloblastomas: a review of the literature and of a 15-year database. J Cranio-Maxillofac Surg 30:273-279, 2002
Department of Oral Pathology & Medicine, Dental School, University of Athens, Greece (Head: Professor A. Sklavounou)
Hellenic Archives of Oral & Maxillofacial Surgery (2010) 2, 91-104
SUMMARY: Ameloblastoma is one of the most frequent epithelial odontogenic tumors, with great clinical significance, mainly due to its local invasive ability. It is a benign lesion and only rarely demonstrates a malignant biological behavior. This study aims at the analytical description of the various clinical and histological varieties of ameloblastoma, as well as at the review of the recent international lite - rature, regarding the origin, classification, biological behavior and treatment of ameloblastoma. Conventional ameloblastoma, mainly developing in the posterior region of the mandible, is the most frequent clinicopathological type, while the unicystic and peripheral ameloblastomas are less common. Among the histological subtypes of the lesion, the follicular is the most common, while increased aggressive biological behavior is attributed to the desmoplastic type. The malignant varieties of ameloblastoma comprise only 1% of the total cases. Currently, it is supported that the development and progression of odontogenic tumors is caused by gene - tic and molecular alterations. Thus, further studies are required in order to clarify the pathogenesis of the odontogenic tumors and to develop new treatment modalities, such as targeted molecular treatment, as alternatives or supplementary to the available surgical methods.
KEY WORDS: Οdontogenic tumor, ameloblastoma, cli ni cal and histological types, pathogenesis.
REFERENCES
Aγγελόπουλος ΑΠ, Παπανικολάου Σ, Αγγελοπούλου Ε: Οδοντογενείς όγκοι. Μοντέρνα Στοματική και Γναθοπροσωπική Παθογογία, 3η Εκ. Λίτσας 2000, σελ 457-484
Abiko Y, Nagayasu H, Takeshima M, Yamazaki M, Nishimura M, Kusano K, Kitajo H, Saitoh M, Kawakami T, Chiba I, Kaku T: Ameloblastic carcinoma ex ameloblastoma: report of a casepossible involvement of CpG island hypermethylation of the p16 gene in malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:72-76, 2007
Ackermann GL, Altini M, Shear M: The unicystic ameloblastoma: a clinicopathologic study of 57 cases. J Oral Pathol 17:541-546, 1988
Andresakis D, Valsamis S, Rapidis A: Current views in the surgical treatment of jaw ameloblastomas. Hellenic Stomatologikal Re - view 49:93-107, 2005 Barnes L, Eveson JW, Reichart P, Sidransky D: Odontogenic tumors, In: World Health Organization classification of tumors: pathology and genetics of head and neck tumors. IARC Press 2005, pp.283-327
Beckley ML, Farhood V, Helfend LK, Alijanian A: Desmoplastic ameloblastomas of the mandible: A case report and review of literature. J Oral Maxillofac Surg 60:194-198, 2002
Bredenkamp JK, Zimmerman MC, Mickel RA: Maxillary ameloblastoma. A potentially lethan neoplasm. Arch Otolaryngol Head Neck Surg 115:99-104, 1989 Buchner A, Sciubba JJ: Peripheral epithelial odontogenic tumors: a review. Oral Surg 63:688-697, 1987
Eleftheriadis E, Sklavounos A, Sotiriadou S, Pittara D, Trigonidis G: Mural ameloblastoma of the maxilla. Case report. Greec J Oral Maxillofac Surg 9:59-63, 1994
Eversole LR, Leider AS, Hansen LS: Ameloblastomas with pronounced desmoplasia. J Oral Maxillofac Surg 42:735-40, 1984
Gardner DG: Some current concepts on the pathology of ameloblastomas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 82:660-669, 1996
Goldblatt LI, Brannon RB, Ellis GL: Squamous odontogenic tumor, report of five cases and review of the literature. Oral Surg Oral Med Oral Pathol 54:187-196, 1982
Ide F, Kusama K, Tanaka A, Sakashita H: Peripheral ameloblastoma is not a hamartoma but rather more of a neoplasm. Oral Oncol 38:318-320, 2002
Ide F, Kusama K: Difficulty in predicting biological behaviour of peripheral ameloblastoma. Oral Oncol 40:651-652, 2004
Kawano K, Mizuki H, Yanagisawa S: Peripheral ameloblastoma exhi - biting an invasion of the alveolar bone: report of a case. J Jap Soc Oral Tum 4:88-92, 1992
Kramer IRH, Pindborg JJ, Shear M. Histological typing of odontogenic tumors. 2nd edition Springer-Verlag Berlin: 1992, pp. 11-25
Kumamoto H, Ooya K: Immunohistochemical detection of retinobla - stoma protein and E2 promoter-binding factor-1 in ameloblastomas. J Oral Pathol Med. 35:183-189, 2006
Kuru H: Ueber das adamantinom. Centralbl f allg path u path anato - mie (iena) 22:291, 1911
Lam KY, Chan ACL, Wu PC, Chau KY, Tideman H, Wei W: Desmo - plastic variant of ameloblastoma in Chinese patients. Br J Oral Maxillofac Surg 36:129-134, 1998
Leider AS, Eversole LR, Barkin ME: Cystic ameloblastoma. Oral Surg Oral Med Oral Pathol 60:624-630, 1985
Li TJ, Browne RM, Matthews JB: Expression of proliferating cell nuclear antigen (PCNA) and Ki-67 in unicystic ameloblastoma. Histopathology 26:219-228, 1995
Martelli-Junior H, Souza L, Santos L, Melo-Filho MR, De Paula AM: Peripheral ameloblastoma: a case report. Oral Surg Oral Med Oral Path Oral Radiol Endod 99:E31-3, 2005
Mendenhall WM, Werning JW, Fernandes R, Malyapa RS, Mendenhall NP: Ameloblastoma. Am J Clin Oncol 30:645-648, 2007
Muller H, Slootweg PG: The Ameloblastoma, the controversial approach to therapy. J Maxillofac Surg 13:79-84, 1985 Nakamura N, Higuchi Y, Mitsuyasu T, Santra F, Ohishi M: Compa - rison of long-term results between different approaches to ame - loblastoma. Oral Surg 93:13-20, 2002
Namin AK, Azad TM, Eslami B, Sarkarat F, Shahrokhi M, Kashanian F: A study of the relationship between ameloblastoma and human papiloma virus. J Oral Maxillofac Surg 61:467-470, 2003
Neville BW, Damma DD, Allen CM, Bouquot JE: Tumors of odontogenic epithelium-Ameloblastoma, In: Neville BW, Damma DD, Allen CM, Bouquot JE: Oral and Maxillofacial Pathology, 3rd edition WB Saunders, Philadelphia: 2009, pp.702-712
Ng KH, Siar CH: Peripheral ameloblastoma with clear cell differentiation. Oral Surg Oral Med Oral Pathol 70:210-213, 1990
Ord RA, Blanchaert RH, Nikitakis NG, Sauk JJ: Ameloblastoma in children. J Oral Maxillofac Surg 60:762-770, 2002
Pekiner FH, Ozbayrak S, Sener BC, Olgaç V, Sinanoğlu A: Peripheral ameloblastoma: a case report. Dentomaxillofac Radiol 36:183- 186, 2007
Philipsen HP, Ormiston IW, Reichart PA: The desmo- and osteoplastic ameloblastoma. Histologic variant or clinicopathologic entity? Case reports. Int J Oral Maxillofac Surg 21:352-357, 1992
Philipsen HP, Reichart PA: Unicystic ameloblastoma. A review of 193 cases from the literature. Oral Oncol. 34:317-325, 1998
Philipsen HP, Reichart PA, Takata T: Desmoplastic ameloblastoma (including “hybrid” lesion of ameloblastoma). Biological profile based on 100 cases from the literature and own files. Oral Oncol 37:455-460, 2001α
Philipsen HP, Reichart PA, Nikai H, Takata T, Kudo Y: Peripheral ameloblastoma: biological profile based on 160 cases from the literature. Oral Oncol 37:17-27, 2001β
Reichart PA, Philipsen HP, Sonner S: Ameloblastoma: biological profile of 3677 cases. Eur J Cancer B Oral Oncol 31B:86-99, 1995
Sampson DE, Pogrel MA: Management of mandibular ameloblastoma: The clinical basis for the treatment algorithm. J Oral Maxillofac Surg 57:1074-1077, 1999
Sehdev MK, Huvos AG, Strong EW, Gerold FP, Willis GW: Ameloblastoma of maxilla and mandible. Cancer 33: 324-333, 1974
Shashikanth MC, Neetha MC, Ali IM, Shambulingappa P: Desmo - plastic ameloblastoma in the maxilla: A case report and review of literature. Indian J Dent Res 18:214-217, 2007 Shetty K: Peripheral ameloblastoma: an etiology from surface epithelium? Case report and review of literature. Oral Oncol Extra 41:211-215, 2005
Takamori M, Yamada Y, Honda K: A case of peripheral ameloblastoma. J Tokyo Med Univ 52:752-757, 1994 T
akigawa T, Matsumoto M, Sekine Y, et al: A case report of amelo - blastoma proliferated like epulis of maxilla. Nihon Univ Dent J 55:920-924, 1981
Tilaveridis I, Dimitrakopoulos I, Lazaridis N: The contribution of marsupialization in the treatment of unicystic ameloblastomas of the mandible. Clinical study. Greec J Oral Maxillofac Surg 13: 119- 123, 1998
Τσιχλάκης Κ, Στεφάνου Ε: Διαφορική διάγνωση οστικών όγκων. Στο: Aγγελόπουλος ΑΠ, Σπυρόπουλος ΝΔ, Τσιχλάκης Κ: Μοντέρνα Στοματική και Γναθοπροσωπική Διάγνωση και Ακτινολογία, 3η Εκ. Λίτσας 2001, σελ 479-481
Vanoven BJ, Parker NP, Petruzzelli GJ: Peripheral ameloblastoma of the maxilla: a case report and literature review. Am J Oto - laryncology 29:357-360, 2008 Vered M, Shohat I, Buchner A: Epidermal growth factor receptor expression in ameloblastoma. Oral Oncol. 39:138-143, 2003
Waldron CA, el-Mofty SK: A histopathologic study of 116 ameloblastomas with special reference to the desmoplastic variant. Oral Surg Oral Med Oral Pathol 63:441-451, 1987
Wettan HL, Patella PA, Freedman PD: Peripheral ameloblastoma: review of the literature and report of recurrence as severe dysplasia. J Oral Maxillofac Surg 59:811-815, 2001
Zhu EX, Okada N, Takagi M: Peripheral ameloblastoma: case report and review of literature. J Oral Maxillofac Surg 53:590-594, 1995
Zwahlen RA, Gratz KW: Maxillary ameloblastomas: a review of the literature and of a 15-year database. J Cranio-Maxillofac Surg 30:273-279, 2002
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