Ameloblastoma of the Sinonasal Tract: Report of a Case with Clinicopathologic Considerations

Abstract

Ameloblastomas are locally aggressive jaw tumours with a high propensity for recurrence and are believed to arise from remnants of dental lamina or odontogenic epithelium. Extragnathic ameloblastomas are unusual, and primary sinonasal tract origin is very uncommon with few cases reported in the literature. We herein report a case of primary sinonasal ameloblastoma presented in a 74-year-old male with nasal obstruction, rhinorrhoea, and sinusitis. Nasal endoscopy showed the right nasal cavity completely obstructed by a polypoid lesion attached to the lateral nasal wall. A preoperative CT scan was performed showing a solid lesion, measuring 2 cm in the maximum diameter, extending from the nasopharynx area with obstruction of the ostiomeatal unit and sphenoethmoidal recess into the lateral pharyngeal space, laterally to the parotid, without continuity with maxillary alveola and antrum. The tumour was completely excised endoscopically, and a final diagnosis of ameloblastoma was rendered. At the 12-month followup, there was no evidence of recurrence.

Ameloblastoma of the Nasal Septum Origin: A Case Report

“…Extragnathic location of the ameloblastoma is unusual and extremely rare [6, 7]. The peak incidence of ameloblastomas usually falls on the third decade of life, with no gender predilection.…”

“…The peak incidence of ameloblastomas usually falls on the third decade of life, with no gender predilection. In comparison to the ameloblastomas of the jaws, it is believed, however, that those located within the sinuses and nasal cavities are more common in older men [5, 6]. …”

“…Ameloblastoma diagnosis is based on the clinical and radiological image with the decisive histopathological confirmation. However, the differential diagnosis can cause problems, especially during the examination of a biopsy of the small fragments of tissues or obtained superficially, due to the lack of assessment of the whole structure of the tumor [5, 6]. Radiologically, the standards of diagnosis of ameloblastomas are computed tomography scans and magnetic resonance imaging [8].…”

“…The ameloblastomas differential diagnosis of the sinonasal region takes into account the most common acute and chronic sinusitis, inverted papilloma, squamous cell carcinoma, adenocarcinoma, angiofibroma, basal cell adenoma, and proliferation of craniopharyngioma [6]. In the case of lesions located in the nasal, septum congenital or acquired pathologies can be suspected.…”

“…In some cases, the endoscopic procedures are applied [5, 6]. The prognosis of the treatment depends mainly on the tumor size and surrounding tissue attachment as well as the resection radicality [5].…”