Ali Mhammad, Qassem Alaq, Tawashi Sara, Ahmad Karam, Khalil Abdul-Karim
Al-Andalus University for Medical Science, Faculty of Dentistry, Syria.
Al-Andalus University for Medical Science, Faculty of Dentistry, Syria.
Int J Surg Case Rep. 2024 Jul;120:109830. doi: 10.1016/j.ijscr.2024.109830. Epub 2024 May 29.
Unicystic ameloblastomas are a rare variant of ameloblastomas, which are characterized by slow growth and being relatively locally aggressive, with the main site of origin being the posterior portion of the mandible, it also refers to those cystic lesions that show clinical, radiographic, or gross features of a jaw cyst.
A 27-year-old female patient presented with a chief complaint of extensive mass of mandible along with severe swelling and numbness of right lips and chin. The oral examination revealed a swelling in the molar region of the right mandible with buccal plate expansion. The radiographic and histopathologic features were consistent with the diagnosis of unicystic ameloblastoma. Consequently, the lesion was surgically removed, and no clinical or radiological recurrence was detected during 5 years post-operative follow-up.
While previous reports of unicystic ameloblastoma in the posterior portion of the jaw showed favorable prognosis lesions appeared as a unilocular entity, this case reports multilocular appearance and aggressive behavior of expansive unicystic ameloblastoma. Furthermore, while some studies linked the unilocular appearance of unicystic ameloblastoma to impacted tooth, our case suggests a possible traumatic link of preexisting lesion into multilocular unicystic ameloblastoma related to impacted tooth.
This case presents a rare multilocular unicystic ameloblastoma appearance, notably with impacted tooth involvement. It also indicates the potential transformation of solid ameloblastoma into unicystic ameloblastom.
单囊性成釉细胞瘤是成釉细胞瘤的一种罕见变体,其特点是生长缓慢且相对具有局部侵袭性,主要起源部位是下颌骨后部,它也指那些具有颌骨囊肿临床、影像学或大体特征的囊性病变。
一名27岁女性患者,主诉下颌骨有广泛肿物,同时伴有右侧唇部和下巴严重肿胀及麻木。口腔检查发现右下颌磨牙区有肿胀,颊侧骨板膨隆。影像学和组织病理学特征与单囊性成釉细胞瘤的诊断相符。因此,对该病变进行了手术切除,术后5年随访期间未发现临床或影像学复发。
虽然先前关于颌骨后部单囊性成釉细胞瘤的报道显示预后良好的病变表现为单房性,但本病例报告了膨胀性单囊性成釉细胞瘤的多房性表现和侵袭性行为。此外,虽然一些研究将单囊性成釉细胞瘤的单房性表现与阻生牙联系起来,但我们的病例提示,与阻生牙相关的先前存在的病变可能因创伤而转变为多房性单囊性成釉细胞瘤。
本病例呈现出罕见的多房性单囊性成釉细胞瘤表现,尤其是累及阻生牙。它还表明实性成釉细胞瘤可能转变为单囊性成釉细胞瘤。