[Recurrent ameloblastoma on a rib graft after 33 years (a case report and review of the literature)].

INTRODUCTION

The recurrence of an ameloblastoma is generally due to insufficient margins of resection or to the aggressiveness of the tumour which is regarded as locally malignant. Recurrencies on autologus osseous graft are rare in the literature. We report the case of a recurrent ameloblastoma on autologus rib graft which occurred 33 years after the surgery.

OBSERVATION

A 59 year old man, underwent at the age of 26 years a tumoral removal of a left mandibular cyst with reconstruction by costal graft. The histopathologic diagnosis was an ameloblastoma with healthy limits and without invasion of the soft tissues. He consulted recently for a tumour located at the left side of the symphysis and presenting an endo-oral component bending at the level of the floor of the mouth. The CTscan objectified a cystic hypodensity well defined inside the rib graft. The patient underwent a surgery performed by a mixed approach (endo-oral and cervical). The tumour was removed with macroscopically healthy margins.

CONCLUSION

The pathogenesis of the recurrence of an ameloblastoma on autologus osseous graft is still not well understood. Thus, it is recommended to get healthy margins in case of en bloc resection requiring to make the limits of the resection at least at one centimeter from the tumour. A very longterm follow-up clinical and radiological is also mandatory.