Metastatic recurrent giant orbital ameloblastoma: A rare case report and literature review.

RATIONALE

Orbital ameloblastoma is a rare benign tumor with metastatic potential, typically exhibiting follicular or plexiform histopathological patterns. Ameloblastoma commonly occurs in the jaws and rarely metastasizes; when it does, the lungs and lymph nodes are the most frequent secondary sites. In the world's reported literature, there are 32 cases of maxillary ameloblastoma metastasizing to the orbit, with only 4 cases of mandibular ameloblastoma metastasizing to the orbit. The mystery lies in its high recurrence rate and aggressive malignant potential despite being classified as a benign tumor, posing a serious threat to the ocular health and quality of life of patients.

PATIENT CONCERNS

This article reports an unusual case of a female patient who was initially diagnosed with mandibular ameloblastoma 17 years ago. Despite undergoing treatment, the tumor recurred and unusually metastasized to the orbit, resulting in a massive lesion that compressed the tissues surrounding the eyeball. She complained of gradual vision loss in her right eye, redness of the eye, and incomplete eyelid closure.

DIAGNOSES

Magnetic resonance imaging (MRI) scans of the orbit indicated a lesion measuring approximately 5.8 cm5.1 cm5.7 cm (centimeter, cm). The clinical diagnosis is recurrent ameloblastoma of the right orbital, with the histopathological subtype being the basal cell type.

INTERVENTIONS

The patient underwent 2 successful partial excisions of the orbital tumor, effectively relieving the compression on the eyeball caused by the tumor.

OUTCOMES

Currently, the 22-month follow-up after the second surgery has shown satisfactory results, with the patient's visual function being preserved.

LESSONS

The patient exhibited significant facial disfigurement at the time of presentation to the ophthalmology department, attributable to the large size of the orbital mass. Inadequate awareness of this uncommon pathology may result in misdiagnosis as basal cell carcinoma or other malignant orbital neoplasms. Despite the preservation of visual function, limited understanding of the disease could lead to overly aggressive surgical management. Therefore, this case is reported to provide insights into the diagnosis, management, and prognosis, serving as a reference for clinicians encountering similar presentations.