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     :
- Unicystic - Described as the mildest form of ameloblastoma and responsible for about 6% of cases, this type is demarcated by an intraluminal or intramural proliferation of a well-circumscribed radiolucency shown on X-rays or CT  .
- Multicystic (or solid) - Accounting for more than 85% of all ameloblastomas, multicystic lesions infiltrate the surrounding tissues and cause the destruction of bone and adjacent soft tissues. On X-rays and CT, an expansive multiloculated radiolucent lesion is seen, and the term "soap bubble-like" appearance is mentioned in some reports . Erosion or unerupted tooth displacement can be observed in this type as well .
- Peripheral - Tumor confinement to the gingival or alveolar mucosa is the defining criteria for a peripheral ameloblastoma, which does not invade the underlying bone . Hence, radiography shows absence of skeletal infiltration, but rare cases of metastatic spread with peripheral forms have been described .
- Malignant - In very rare cases, ameloblastomas become malignant tumors (or arise de novo as primary malignant lesions) .
- Desmoplastic ameloblastoma (DA) is another variant of this tumor, distinguished by its development in the anterior jaw and a mixed radiolucent-radioopaque appearance  .
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 .
RESULTS: Twenty-seven patients were included, managed by conservative treatment (CT) in 22 cases and radical treatment (RT) in 14 cases. [ncbi.nlm.nih.gov]
However, in a detailed study of 345 patients, chemotherapy and radiation therapy was contraindicated for the treatment of ameloblastomas. Thus, surgery is the most common treatment of this neoplasm. [en.wikipedia.org]
The purpose of this paper was to review the literature and to demonstrate a rare case for an improved understanding of the behaviour and prognosis of DA. [ncbi.nlm.nih.gov]
However, the prognosis is generally regarded as poor/good/excellent. [wikidoc.org]
Comparisons of prognosis and Ki-67 expression were carried out by statistic methods. [nature.com]
CONCLUSION: The study highlights, the possible etiological role of location influencing the incidence and recurrence rates of ameloblastomas. [ncbi.nlm.nih.gov]
Updated, reorganized, and revised throughout, this highly lauded three-volume reference provides an interdisciplinary approach to the diagnosis, treatment, and management of head and neck diseases, including the incidence, etiology, clinical presentation [books.google.com]
OBJECTIVE: To study the epidemiological and histological characteristics of ameloblastoma. To study Ki67 and CD10 immunostaining in ameloblastoma and to investigate a possible correlation between these two markers and recurrence of this tumour. [ncbi.nlm.nih.gov]
These epidemiologic observations give rise to speculation as to whether some component of the South African Black diet or other environmental substance might possibly be an etiologic factor in ameloblastoma. [dx.doi.org]
"The Epidemiology, treatment, and complication of ameloblastoma in East-Indonesia: 6 years retrospective study". Medicina Oral Patología Oral y Cirugia Bucal : 0–0. doi : 10.4317/medoral.22185. ISSN 1698-6946. [wikidoc.org]
Understanding its pathophysiology based on various views and clinical implications in terms of its biologic behavior are brought to light in this paper. [ncbi.nlm.nih.gov]
Genome‐Scale Biology, Research Programs Unit, University of Helsinki, Finland Search for more papers by this author Blandine Ruhin Assistance Publique‐Hôpitaux de Paris, Maxillofacial and Stomatology Department, Pitié‐Salpêtrière Hospital, and Molecular Oral Pathophysiology [doi.org]
Ameloblastoma has no established preventive measures although majority of patients are between ages 30 and 60 years. [ncbi.nlm.nih.gov]
Conservative accession toward treatment of plexiform ameloblastoma in an 11-year-old girl 1 Department of Pedodontics and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India 2 Department of Periodontolog, Seema Dental [ijds.in]
Treatment Aggressive surgery is the only treatment to remove the lesion and prevent recurrence. The procedure requires removing the healthy bone surrounding the tumor so that no tumor cells are left behind to allow it to regrow. [colgate.com]
Radical surge ry should be used for the multicystic ameloblastoma to prevent the recurrence. The follicular ameloblastoma were thought to have a higher recurrence rate than unicystic or plexiform.  References Gümgüm S, Hoşgören B (2005). [wikidoc.org]
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