Ameloblastoma is a rare odontogenic and primarily benign tumor developing in the upper jaw or mandible. It is often diagnosed incidentally, as many patients are asymptomatic. However, aggressive growth and the potential for malignant transformation can induce symptoms, which should be evaluated through a detailed workup, with an emphasis on imaging studies such as computed tomography.
Although they are considered to be one of the most common odontogenic tumors, ameloblastomas are a rare occurrence in clinical practice . Their incidence is equal in both genders and may be diagnosed at any anytime between the first and sixth decade of life   . However, the majority of tumors are identified in the third and fourth decades of life, when a slow-growing painless mass is observed   . The mandible (the ramus and the angle) is the predominant site of ameloblastoma development, whereas the upper jaw (the canine or molar regions) is the second important location  . Ameloblastomas, when asymptomatic and minimally aggressive, are frequently associated with an unerupted third molar , but when the tumor exhibits more severe proliferation and extends into adjacent tissues, various symptoms may appear. Facial swelling and/or asymmetry, pain, displacement and loosening of the teeth, mucosal ulceration (due to the protraction of the tumor), as well as ill-fitting dentures, obstruction of the nasal passage and even fractures of the surrounding bones are documented presentations of ameloblastoma     . In approximately 2% of cases, the tumor undergoes malignant transformation and metastatic dissemination can pose a significant and even life-threatening risk for the patient  . For this reason, an early diagnosis not only carries a less aggressive approach to therapy but also minimizes the chances of an adverse outcome. More importantly, some forms of ameloblastoma can recur after therapy, and even metastasize, thus strengthening the role of long-term patient follow-up  .
Any facial symptoms must be taken seriously, but in order to obtain a complete view of their onset and progress, a detailed patient history should be the first step during workup. Furthermore, a meticulous physical examination focused on the oral cavity and a full ear nose and throat (ENT) exam can confirm some of the possible symptoms of ameloblastoma and detect a mass in the mandible or the upper jaw. In that case, imaging studies, the gold standard when it comes to evaluating a mass in the oral cavity, must be employed. Based on the appearance of the tumor on radiography, computed tomography (CT), or magnetic resonance imaging (MRI), four clinical types are described in the literature     :
To make a final diagnosis, a biopsy of the lesion (often performed after surgical removal of the tumor) and subsequent histopathological examination is necessary. On the basis of histological features, ameloblastomas are subdivided into follicular, plexiform, granular and acanthomatous types .