Follicular Ameloblastoma: Resection And Reconstruction Using Pectoralis Major Mycocutaneous Flap

In 2005, the World Health Organization histologically classified ameloblastomas into solid/multicystic, extra osseous/peripheral, desmoplastic, and unicystic types. Solid/multicystic ameloblastomas were further divided into follicular and plexiform types. The follicular type has 4 subtypes, the spindle cell type, acanthomatous type, granular type, and basal cell type. The surgical options for Ameloblastoma vary from simple enucleation (with or without bony curettage) to radical excision. The histological infiltration of these tumours beyond macroscopic and even radiological boundaries allows creation of safety margins to promote recurrences. Thus, tumour enucleation and curettage may cause not only an unacceptable likelihood of recurrence but also an increasing risk of fractures due to the maintenance of unhealthy and/or weakened bony structures. Considering undetectable microscopic spreading, especially through the central cancellous bone, the radical surgical excision appears as the modality of treatment with a reasonable curative rate for both primary and recurrent ameloblastomas.