Ameloblastoma Revisited

Ameloblastoma is a benign but locally aggressive neoplasm of the odontogenic epithelium, the treatment of which is controversial. A review was made of 22 patients treated for histologically diagnosed ameloblastoma between January 1975 and January 2000. We recorded data relating to patient sex, age, site of involvement, histologic type, surgical treatment, and number of recurrences. All ameloblastomas were located in the mandible. The most common histologic patterns were follicular and plexiform lesions. A total of 22.7% of the tumors were unicystic ameloblastomas. Unicystic lesions were seen to affect younger patients than the rest of the histologic types. Eighteen patients were initially treated in our center, and 4 cases were referred to our center for secondary treatment. The number of recurrences was significantly lower in patients initially treated in our center. Primary treatment comprised enucleation and bone curettage in 10 cases and radical surgery in 7. Forty percent of the unicystic lesions and 53.3% of the non-unicystic ameloblastomas of our study presented at least 1 recurrence. Ameloblastoma is a polymorphic neoplasm for which the treatment is conditioned by a number of clinical and histologic factors. An individualized preoperative study is essential for treatment.