Mural Unicystic Ameloblastoma Crossing the Midline: A Rare Case Report

Abstract

Ameloblastoma is a benign odontogenic neoplasm which frequently affects the mandible. The term ameloblastoma includes several clinico-radiological and histological types. Apart from the most commonly encountered clinico-pathologic models there are few variants, whose biological profile is unknown or not elicited. The reason for lack of understanding is the scarcity of case report published in the literature. Among the types, unicystic ameloblastoma is the least encountered either it presents as unilocular or multilocular radiolucency, but peculiar radiographic presentation of multilocular radiolucency in posterior mandible with unilocular radiographic appearance crossing the midline is extremely rare, which has not been reported yet. Here we report a distinctive case of mural unicystic ameloblastoma of mandible in a 17-year-old-girl with the radiographic presentation as mentioned above.

Unicystic Mural Ameloblastoma: An Unusual Case Report

“…It usually occurs in a younger age group of 16–20 years, with about 50% of the cases occurring in the second decade of life as in our case [9, 10]. The gender distribution shows a slight male predilection with a male to female ratio of 1.6 : 1.…”

“…However, when the tumor is not associated with an unerupted tooth, the gender ratio is reversed to a male to female ratio of 1 : 1.8 [11]. More than 90% are located in the mandible in the posterior region, followed by the parasymphysis region, the anterior maxilla, and the posterior maxilla [9]. UCA is usually asymptomatic, although a large tumor may cause painless swelling of the jaws with facial asymmetry [9].…”

“…More than 90% are located in the mandible in the posterior region, followed by the parasymphysis region, the anterior maxilla, and the posterior maxilla [9]. UCA is usually asymptomatic, although a large tumor may cause painless swelling of the jaws with facial asymmetry [9]. Mucosal ulceration is rare but may be caused by continued growth of the tumor [12].…”

Unicystic Ameloblastoma with Mural Proliferation Managed by Conservative Treatment

“…Just as a mural painting covers only the surface of a wall, a mural ameloblastoma does not penetrate the epithelial lining of a cyst [7, 11, 12]. Due to the misapplication of the classification, statistics concerning recurrence rates of such so-called ameloblastomas related to the use of specific treatment approaches have been inaccurate and in some cases dangerously misleading [7].…”

Mural Variant of UnicysticAmeloblastoma

“…It is a slow growing, locally aggressive which is known to metastasizes rarely but is known to have a high rate of recurrence (55-90%) if not removed adequately [7] .UnicysticAmeloblastoma (UA) accounting for around 6% of Ameloblastomas is known to usually occur in a younger age group of 16-20 years, with about 50% of the cases occurring in the second decade of life [8,9] . The gender distribution shows a slight male predilection with a male to female ratio of 1.6 :1, however the ratio is changed when the tumor is not associated with an unerupted tooth, and ratio of male to female ratio being 1:1.8 [2] .…”