Maxillary Ameloblastoma with Intracranial Invasion —Case Report—

Sato, Kazuei; Sudo, S.; Fukuya, Yasuhiko; Sasaki, Hideo

doi:10.2176/nmc.34.704

Cited by 20 publications

(15 citation statements)

References 13 publications

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“…The relationship between tumor location and recurrence risk has been, thus far, controversial. Multiple studies point to a conclusion that maxillary ameloblastomas are inherently more difficult to manage, with extensive disease at presentation, multiple recurrences, and locally aggressive behavior [2,14,15]. However, the cumulative data comparing recurrence rates of mandibular and maxillary ameloblastomas do not show significant difference between the two sites [1,9].…”

Section: Discussionmentioning

confidence: 99%

“…Although most tumors recur within 5 years of original diagnosis, late recurrences are not uncommon, and were seen in 23 % of the patients in the current study. While neglected and recurrent ameloblastoma can cause significant morbidity, mortality is extremely rare and is seen typically in a setting of maxillary ameloblastoma extending into the cranium [2,14,15]. The rare metastasizing ameloblastoma and ameloblastic carcinoma, each described in up to 2 % of patients with ameloblastoma, can also infrequently lead to mortality [2,4,5,8,21].…”

Section: Discussionmentioning

confidence: 99%

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Ameloblastoma: 25 Year Experience at a Single Institution

Milman

Ying

Pan

et al. 2016

Head and Neck Pathol

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Ameloblastoma is a rare, locally aggressive odontogenic neoplasm, accounting for fewer than 1 % of head and neck tumors. Recent literature suggests that the initial surgical approach and histologic growth patterns are the most important prognostic determinants in ameloblastoma. The aim of this study was to compare the clinical presentation, management, and outcomes of patients with ameloblastoma with data reported in the literature; the study spanned 2 decades at a single institution. The institution's database was searched for all patients with pathologically confirmed ameloblastoma, diagnosed between 1990 and 2015. The data collected included sex, age, clinical and imaging findings, management, histologic pattern, clearance of surgical margins, length of follow-up, time to recurrence, and disease-related mortality. The potential risk factors of recurrence were evaluated using log-rank test, proportional hazard model, and Fisher exact test. Review of the database yielded 54 patients with pathologically confirmed ameloblastoma and follow-up. Recurrence was noted in 13 (24 %) patients. Surgical approach was associated with the risk of recurrence (6.1 % following radical resection vs. 52 % following limited surgery, p = 0.002). There were trends toward higher recurrence rate in the group with pathologically documented positive margins (p = 0.054) and in follicular ameloblastoma (p = 0.35). Transformation into ameloblastic carcinoma was identified in two patients. There was no disease-related mortality. Our study confirms the recent data regarding the importance of radical surgical resection in management of ameloblastoma. Surgical approach appears to be the strongest predictor of tumor clearance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ameloblastoma: 25 Year Experience at a Single Institution

Milman

Ying

Pan

et al. 2016

Head and Neck Pathol

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“…8–10 Thus, collaborative surgical care is frequently required, which includes the oral and maxillofacial surgeons, otolaryngologists, plastic surgeons, and ophthalmologists. 7,9,11 Understanding of the biologic behavior of this tumor, the signs and symptoms which herald orbital involvement, and the recommended current approach to care, are necessary to appropriately manage patients with this potentially lethal neoplasm. To the best of our knowledge, only 3 patients with orbital involvement by maxillary ameloblastoma have been described in detail in ophthalmic literature.…”

Section: Introductionmentioning

confidence: 99%

Maxillary Ameloblastoma with Orbital Involvement: An Institutional Experience and Literature Review

Milman

Lee²,

LiVolsi

2016

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose To describe 8 patients with orbital involvement by ameloblastoma and to review the literature on this topic. Methods The electronic medical records and pathology databases of the Hospital of the University of Pennsylvania were searched to identify all patients with histopathologically confirmed ameloblastoma diagnosed between 1990 and 2015. PubMed database was searched for all well-documented cases of maxillary ameloblastoma and ameloblastic carcinoma exameloblastoma with orbital involvement published in the English literature. The information collected on the compiled 23 patients included age, sex, clinical presentation, imaging findings, management, tumor histopathologic features, and follow up. Results Review of medical records identified 8 patients with orbital involvement by ameloblastoma. Literature search yielded 15 patients with well-documented orbital involvement by ameloblastoma. Most tumors occurred in men (19 of 23, M:F = 4–5:1) with an average age of 56 years. The overall rates of recurrence, visual compromise, death, and confirmed disease-related mortality were 70% (16/23), 26% (6/23), 39% (9/23), and 22% (5/23), respectively. The initial surgical approach correlated with prognosis. The rates of recurrence, orbital exenteration, and mortality in the cohort managed with conservative surgery or partial maxillectomy were 57% (8/14), 29% (4/14), and 50% (7/14), respectively. In contrast, the patients initially managed with a radical resection had substantially lower frequencies of tumor recurrence (2/7, 29%), exenteration (1/7, 14%), and death (1/7, 14%). Malignant transformation to ameloblastic carcinoma occurred in the setting of recurrent disease in 3 patients and in 1 patient with prolonged duration of symptoms, suggestive of a long-standing tumor. Conclusions Maxillary ameloblastoma can rarely involve the orbit, leading to significant ocular morbidity and occasional mortality. Prompt radical resection of the tumor has the potential to decrease the likelihood of recurrence and visual compromise, and can improve survival.

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“…5,6 Only a few cases are reported, [7][8][9][10][11][12][13][14][15] and only some grow aggressive and involve the orbit, the nasal cavity, and even the sinuses. 3,[16][17][18] Nevertheless, some cases of intracranial extension of ameloblastomas are also reported in the literature. [19][20][21] We present a case of an extensive ameloblastoma originating from the maxilla and involving the nasal cavity, the paranasal sinus, the frontal sinus, the left orbit, the frontal cranial fossa, and both frontal lobes of the brain.…”

Section: Introductionmentioning

confidence: 99%

Intracranial Ameloblastoma Arising from the Maxilla: An Interdisciplinary Surgical Approach

Quick-Weller

Koch

Dinc

et al. 2016

J Neurol Surg A Cent Eur Neurosurg

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Ameloblastomas are a rare tumor entity accounting for only 10% of all odontogenic tumors. They mostly originate from the mandible. Only a few cases are known to grow aggressively and to invade the orbit, nasal cavity, or even the brain. We present the case of a 57-year-old patient who was admitted with a huge tumor involving the nasal cavity, the left maxilla, and the anterior fossa. Histologic diagnosis was made by biopsy. A combined two-stage neurosurgical maxillofacial approach was planned. First the intracranial tumor mass was removed using bifrontal trepanation. A duraplasty was sewn in to cover the brain. In the second procedure, a combined bifrontal and midfacial approach was used by craniofacial plastic surgeons and neurosurgeons. A perisinusoidal tumor mass and retropharyngeal tumor mass was removed up to the skull base. The left orbit was completely exenterated, and a fibular bone-muscle graft was used for palatal, orbital, and facial reconstruction. The facial vein and artery were carefully prepared to feed the bone-muscle graft by end-to-end anastomoses. Ameloblastomas are very rare slow-growing tumors that show a tendency to recur. They are responsible for only 1% of all oral tumors. Their growth can be enormous, and they can extend into sinusoidal cavities, the orbit, and the brain. Complex and extensive palliative surgery can ease the concerns of these patients and prolong their survival.

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Maxillary Ameloblastoma with Intracranial Invasion —Case Report—

Cited by 20 publications

References 13 publications

Ameloblastoma: 25 Year Experience at a Single Institution

Ameloblastoma: 25 Year Experience at a Single Institution

Maxillary Ameloblastoma with Orbital Involvement: An Institutional Experience and Literature Review

Intracranial Ameloblastoma Arising from the Maxilla: An Interdisciplinary Surgical Approach

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