Less is more: The conservative management of Pediatric Ameloblastoma - A case report

Rajan Santhosh, Singaram Mamta

Hellenic Archives of Oral & Maxillofacial Surgery (2022) 2, 141-146

DOI https://dx.doi.org/10.54936/haoms232141146

Ameloblastoma is a benign tumor of the jaws of odontogenic origin, known for its aggressive behavior involving adjacent vital structures. Though the tumor predominantly involves the adolescents in their second and adults in third decades of life, it is very rare below 10 years of age. The treatment of ameloblastoma is controversial as the surgeon is left to choose between a conservative, which results in recurrence or an aggressive approach, which causes the resection of vital structures in close proximity. Surgical treatment of ameloblastoma in children should follow the principles of craniofacial growth due to the incomplete growth of the jaws and the pathological aspects of the tumor. In this paper, we discuss a rare case of plexiform ameloblastoma in a 9 year old child treated conservatively using total enucleation, chemical cauterization followed by extraction of involved tooth, with a good follow up prognosis of the case.

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REFERENCES
  1. Fregnani ER, da Cruz Perez DE, de Almeida OP, Kowalski, LP, Soares FA, de Abreu Alves F. Clinicopathological study and treatment  outcomes of  121 cases of  ameloblastomas. International  Journal  of  Oral  and  Maxillofacial  Surgery, 2010;39(2):145–149
  2. Payne SJ, Albert TW, Lighthall JG, Management of ameloblastoma in the pediatric population, Operative Techniques in Otolaryngology-Head and Neck Surgery,2015;26(3):168–174
  3. Zhang J, Gu Z, Jiang L, et al. Ameloblastoma in children and adolescents. Br J Oral Maxillofac Surg. 2010;48(7):549-54.
  4. Taylor GI, Reconstruction of the mandible with free composite iliac bone grafts. Ann Plast Surg1982;9: 361–376
  5. David DJ, Tan E, Katsaros J, Sheen R, Mandibular reconstruction with vascularized iliac crest: a 10-year experience. PlastReconstr Surg,1988;82: 792–803.
  6. Pogrel MA, Montes DM. Is there a role for enucleation in the management of ameloblastoma? Int J Oral Maxillofac Surg. 2009;38:807–12
  7. Small, L.  A. & Waldron, C.  A.  Ameloblastoma of the jaws.  Oral Surg. Oral Med. Oral Pathol., 8:281-97, 1955.
  8. Topazian RC, Ameloblastoma 4 year old child, Oral Surg Oral Med Oral Pathol, 1964;17(5):581-585.
  9. YOUNG DR, ROBINSON M. Ameloblastomas in children. Report of a case. Oral Surg Oral Med Oral Pathol. 1962;15:1155-62.
  10. Chaudhary Z, Krishnan S, Sharma P, Sharma R, Kumar P. A review of literature on ameloblastoma in children and adolescents and a rare case report of ameloblastoma in a 3-year-old child. Craniomaxillofac Trauma Reconstr. 2012;5(3):161-8
  11. Ord RA, Blanchaert RH, Jr, Nikitakis NG, Sauk JJ. Ameloblastoma in children. J Oral Maxillofac Surg. 2002;60:762–70
  12. Arotiba GT, Ladeinde AL, Arotiba JT, Ajike SO, Ugboko VI, Ajayi O. Ameloblastoma in Nigerian children and adolescents: a review of 79 cases. J Oral Maxillofac Surg. 2005;63:747–751. 
  13. Chidzonga MM. Ameloblastoma in children. The Zimbabwean experience. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 1996;81:168–170
  14. Fung, E. M. Ameloblastomas.  Int. J. Oral Surg,1978;7:305.
  15. Simon EN, Merkx MA, Vuhahula E, Ngassapa D, Stoelinga PJ. A 4-year prospective study on epidemiology and clinicopathological presentation of odontogenic tumors in Tanzania. Oral Surg Oral Med Oral Pathol Oral RadiolEndod 2005;99: 598–602
  16. Lawal AO, Adisa AO, Popoola BO. Odontogenictumors in children and adolescents: a review of forty-eight cases. Ann Ib Postgrad Med 2013;11:7–11.
  17. Borghesi A, Nardi C, Giannitto C, Tironi A, Maroldi R, DiBartolomeo F, Preda L. Odontogenickeratocyst: imaging features of a benign lesion with an aggressive behaviour. Insights Imaging. 2018;9(5):883-897
  18. Olaitan A A, Adeola D S, Adekeye E O. Ameloblastoma: clinical features and management of 315 cases from Kaduna, Nigeria. J Craniomaxillofac Surg. 1993;21(8):351–355
  19. Hong J, Yun P-Y, Chung I-H, et al. Long-term follow up on recurrence of 305 ameloblastoma cases. Int J Oral Maxillofac Surg. 2007;36(4):283-8
  20. Gardner DG, Corio RL. Plexiformunicysticameloblastoma: a variant of ameloblastomas with a low recurrence after enucleation. Cancer. 1984;53(8):1730–1735
  21. Rubio ED, Mombrú CM. Spontaneous Bone Healing after Cysts Enucleation without Bone Grafting Materials: A Randomized Clinical Study. Craniomaxillofac Trauma Reconstr. 2015;8(1):14–22.
  22. Chacko R, Kumar S, Paul A. Arvind. Spontaneous Bone Regeneration after Enucleation of Large Jaw Cysts: A Digital Radiographic Analysis of 44 Consecutive Cases. JCDR. 2015;9(9):ZC84–9. 
  23. Nakamura N, Higuchi Y, Mitsuyasu T, Sandra F, Ohishi M. Comparison of long-term results between different approaches to ameloblastoma. Oral Surg Oral Med Oral Pathol Oral RadiolEndod, 2002;93: 13-20
  24. Ueno S, Nakamura S, Mushimoto K, Shirasu R. A clinicopathologic study of ameloblastoma. J Oral MaxillofacSurg 1986;44:361-365.
  25. Chiapasco M, Rossi A, Motta JJ, Crescentini M: Spontaneous bone regeneration after enucleation of large mandibular cysts: a radiographic computed analysis of 27 consecutive cases. J Oral MaxillofacSurg 58: 942e948, 2000 discussion 949
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Triannual medical Journal - The official publication of the Hellenic Association for Oral and Maxillofacial Surgery. ISSN 1108-829​X, ISSN (electronic) 2241-5939
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