ameloblastoma

Ameloblastoma is a benign but locally aggressive odontogenic tumor that arises from remnants of the enamel organ or other odontogenic epithelium. It most commonly affects the mandible, particularly the posterior region, and tends to occur in adults, often in the 20s to 60s, with a slight male predominance.

Patients usually present with a slow-growing swelling of the jaw, which may be painless but can cause facial asymmetry, tooth displacement, loosening, or numbness if nerves are affected. The clinical course can be long, and symptoms may be mild early on. Radiographically, ameloblastoma can appear as a multilocular radiolucency with a soap-bubble or honeycomb pattern, though unilocular forms can resemble cysts. Lesions may be associated with impacted teeth in some cases.

Histologically, the tumor shows various patterns, most commonly solid/multicystic or unicystic subtypes. The solid/multicystic type is the traditional form and is usually more aggressive, whereas unicystic ameloblastoma tends to occur in younger patients and may respond to more conservative treatment. Peripheral ameloblastoma arises in the soft tissues overlying the jaw bones.

Management is primarily surgical. Solid/multicystic lesions require wide resection with margins or segmental resection, often with reconstructive procedures. Unicystic and select peripheral cases may be treated conservatively with enucleation or curettage, sometimes with adjunctive measures to reduce recurrence. Recurrence is common after incomplete removal, underscoring the need for long-term follow-up, sometimes for many years. Metastasis is rare, and malignant transformation is uncommon.