Ameloblastoma: clinical features and management of 21 cases.

A retrospective study of 21 patients with ameloblastoma, operated in Tikur Anbessa Hospital between September 1990 to August 1997, is reported. There were 14 male and 7 female patients. The mean age at diagnosis was 26 years. There were three paediatric patients aged 6,9 and 12 years. The average duration of illness was 4 years with a wide range of 3 months to 12 years. Complete medical record was recovered for 9 patients. Clinical features were pain on chewing in 7 out of 9 (78%) and mandibular swelling in 5 out of 9 (56%) of which there was ulceration with bloody and/or purulent discharge. Diagnosis was made by clinical presentation, x-ray of the mandible and fine needle aspiration cytology. Two patients had malignant ameloblastoma as confirmed by excisional biopsy. All patients were managed surgically. Of nine patients whose clinical records could be retrieved, five had hemimandibulectomy, two had segmental resection and two had local resection and curettage. Recurrences were seen in two patients. Post-operative stay was complicated by infection and salivary fistula in 55%; these patients were discharged after 29.6 days as compared to 14 days in those that were not complicated. One patient with malignant tumor needed tracheostomy and intensive care for one week. There were no deaths. Ameloblastoma is predominantly a benign disabling but curable disease. Radical excision is recommended to avoid recurrence.