Ameloblastomas vs recurrent ameloblastomas: a systematic review

Abstract

Introduction: Ameloblastoma is an odontogenic tumour with high recurrence rate. The objective of the present study was to evaluate existing literature regarding clinical, radiographic, histopathologic features, treatment, and recurrence rate of ameloblastomas and compare it with features of recurrent ameloblastomas. Materials and methods: A systematic review was done based on the PRISMA statement. Search was performed in “Pubmed” database with search terminology “recurrent ameloblastoma”, “ameloblastoma recurrence” for articles published between 2010 and 2020. Data were extracted from full‐text articles and discussed. Results: Out of 515 articles, 16 articles fulfilled the inclusion and exclusion criteria. Data was analysed in two sections. The first with 10 publications assessed features of ameloblastoma in general and their recurrence rate while the second section evaluated features of only recurrent ameloblastomas in 6 publications. There were 234 recurrences in 936 cases with recurrence rate of 23.50%. Male predominance was noted and mandible was commonly affected. Solid/multicystic ameloblastomas formed 74.5% of the tumours and unicystic formed 23.3%. The recurrence rate after conservative treatment was 64.9% and after radical treatment was 12%. Conclusions: The main factors for recurrence were multilocular ameloblastomas, follicular histopathology and conservative treatment.

Does BRAF mutation status and related clinicopathological factors affect the recurrence rate of ameloblastoma? A systematic review, meta‐analysis and metaregression

“…2 It has also been reported that tumours located in the mandible have a higher recurrence rate than those in the maxilla and younger patients have a higher risk of recurrence than older patients. 18 We found significantly higher odds of mandibular lesion being BRAFv600e+, and it has been reported that a significantly higher recurrence of ameloblastoma is seen in mandible. 25,26 Thus it may appear that the higher recurrence in mandibular lesions could be related to BRAFv600e+ status, however, our analysis did not reveal any significant difference in recurrence between the two groups, even after taking jaw site as a covariate.…”

“…Therefore, results of the current study should be interpreted with caution since we were unable to extract those data due to either unreported information or the heterogeneity in the included studies' presentation methods. Nevertheless, the potential for recurrence in ameloblastoma is multifactorial and unlikely to be dependent on BRAF mutational status alone as reported in this recent meta‐analysis of primary versus recurrent ameloblastoma 18 . In this context, it should be noted that the recently recognised adenoid ameloblastoma lacks BRAF mutation despite demonstrating a more aggressive clinical behaviour and up to 45% recurrence compared to conventional ameloblastoma 19–22 .…”

“…Although the unicystic subtype of ameloblastoma has been reported to have a lower recurrence rate compared to the conventional subtypes, we lacked sufficient data to test this hypothesis in BRAF v600e + group 2 . It has also been reported that tumours located in the mandible have a higher recurrence rate than those in the maxilla and younger patients have a higher risk of recurrence than older patients 18 . We found significantly higher odds of mandibular lesion being BRAFv600e +, and it has been reported that a significantly higher recurrence of ameloblastoma is seen in mandible 25,26 .…”

“…Nevertheless, the potential for recurrence in ameloblastoma is multifactorial and unlikely to be dependent on BRAF mutational status alone as reported in this recent meta-analysis of primary versus recurrent ameloblastoma. 18 In this context, it should be noted that the recently recognised adenoid ameloblastoma lacks BRAF mutation despite demonstrating a more aggressive clinical behaviour and up to 45% recurrence compared to conventional ameloblastoma. [19][20][21][22] However, we did observe a statistically significant higher proportion of recurrent BRAFv600e+ ameloblastomas in females, indicating that this clinical subgroup may indeed have a higher risk of recurrence if the lesion is BRAFv600e+.…”

Study of Ki67 in odontogenic benign tumors

“…4 However, a male predominance has been described by other authors. [18][19][20] This difference could be explained by a large number of cemento-osseous dysplasia cases, often seen and encountered in melanodermal adult women. 21 These tumors can be found at any age with a peak in young adults.…”