Maxillary Unicystic Ameloblastoma: A Case Report

Auteurs: Nawres Ghadhab, Lamia Oualha, Ghada Bouslama, Nour Ben Massoud ,Aya Mtiri , Souha Boudegga Ben Youssef

Abstract:

Background:

Ameloblastoma is a benign epithelial odontogenic tumor. It is often aggressive and destructive, with the capacity to attain great size, erode bone and invade adjacent structures. Unicystic ameloblastoma is a rare odontogenic lesion, with clinical, radiographic and gross features of jaw cysts. The lesion histologically shows typical ameloblastomatous epithelium lining part of the cyst cavity with or without and/or mural tumor growth. Unicystic ameloblastoma usually presents in posterior mandibular ramus region, while it is rare and atypical in posterior maxillary region.

Case presentation:

We report a case of 60 year old male patient with a medical history of diabetes and hypertension who was referred by his dentist for further evaluation due to delayed healing of the extraction socket of tooth (27), removed two years earlier. Clinical examination revealed halitosis and a non-healed socket with epithelialized walls and no bone exposure with suspicion of an oroantral communication. The Valsalva maneuver was negative. Initial panoramic radiography revealed an irregularly healed tooth (27) socket with indistinct margins and a heterogeneous left maxillary sinus floor. Computed tomography showed a well-defined hypodense lesion lacking a sclerotic border, displacing the left maxillary sinus and nearly obliterating its lumen. The patient was treated by surgical enucleation of the lesion and extraction of first molar tooth which was present inside the lesion. The histopathological examination of the lesion revealed confirmed finding for unicystic ameloblastoma mural form. No recurrence was observed in 1 year follow‑up.

Conclusion:

Maxillary region is considered a rare and atypical location for unicystic ameloblastoma. We emphasize the importance of differential diagnosis of an odontogenic lesion with common clinical and radiological features that will impact the treatment planning and follow up. As oral health providers we should be aware that the unilocular radiolucencies may be unicystic ameloblastoma.

télécharger en pdf