Ameloblastoma natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3]. Common complications of [disease name] include [complication 1], [complication 2], and [complication 3]. Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
Natural History
- The majority of ameloblastomas expand slowly, they do so by infiltrating into the adjacent bone marrow and, if allowed to grow until there is extensive jaw expansion, they may penetrate the cortex and extend into muscle and other local soft tissues. The resulting tumors or cysts are usually benign but the tissue growth may be aggressive in the involved area. On rare occasions, tissue near the jaws, such as around the sinuses and eye sockets, may become involved as well. The tissues involved are most often those that give rise to the teeth so that ameloblastoma may cause facial distortion. Malignancy is uncommon as are metastases, but they do occur. Ameloblastoma is characterized by an abnormal growth in the jaw or sinus area, often at the site of the third molar. The tumors or cysts may be aggressive and may spread to the eye socket, nose, and skull.
- Although ameloblastoma is considered a benign odontogenic tumor, it is locally aggressive, slow growing, and has a high propensity for local recurrence if not removed completely.
- It is important for ameloblastoma to be diagnosed and treated early in order to stop growth of the tumors and possible progression to cancer. Although it is uncommon, ameloblastomas have been known to become malignant and spread to other parts of the body, especially to the lungs.
- Ameloblastomas have a significant recurrence rate traditionally ranging between 5% and 30% over periods ranging from 5 to 15 years, thus necessitating resection. The initial surgical treatment must be carefully and scrupulously done to avoid recurrence. Ameloblastomas do not usually become malignant. Evidence suggests that ameloblastoma is more likely to become malignant if the condition reoccurs after surgery.The initial surgical treatment must be carefully and scrupulously done to avoid recurrence.
Complications
According to World Health Organization (WHO) ameloblastoma is a benign tumor. Metastases to the lungs or central nervous system (CNS) have rarely been reported. Complications of ameloblastoma include the following:
- Breathing difficulty
- Pain and facial deformity
- Secondary infection of the tumor
- The recurrence rate of these tumors is 25-30%. The tumor can recur after treatment and hence, a close follow-up is needed.
Prognosis
Simple unicystic lesions are less common but have a better prognosis. Simple (no nodule) variant will not be diagnosable on radiography, as it will be indistinguishable form other more common cysts. Luminal variant, has a single nodule projecting into the cyst. Mural variant has multiple nodules (often only microscopic) in the wall of the cyst. The latter has an elevated risk of recurrence. Generally, complete surgical excision with wide surgical margins result in a good prognosis for Ameloblastoma The tissue growth may be removed, but newer growths could be a frequent occurrence