Radiographic estimation of the growth rate of initially underdiagnosed ameloblastomas

Abstract

Background To evaluate the specific growth rate (SGR) of ameloblastoma. Material and Methods Cases of ameloblastoma initially underdiagnosed (e.g. cases overlooked or diagnosed as reactive lesions) which had adequate radiographic documentation to evaluate their progression were retrospectively selected. Two panoramic radiographs were analyzed to determine the specific growth rate (SGR) of each tumor, defined as the logarithm of the ratio of final tumor area (when the diagnosis of ameloblastoma was made) to the initial tumor area (when the lesion was underdiagnosed), divided by the time interval between the radiographic images. The tumor area was measured using the software ImageJ. Results Twelve patients with mandibular ameloblastomas were selected, including 5 males and 7 females, with a mean age of 24.9 years (range: 14-61 years). In four cases, the lesion was associated with the crown of an impacted third molar. In three cases, it was initially diagnosed as a periapical lesion. Three cases were extrafollicular and were not noticed in the initial radiographs. Two cases were initially diagnosed as ameloblastoma, but the surgery was delayed for personal reasons. The mean interval of time between the two radiographic images was 4.3 years (range: 0.4-9 years). Based on our analysis, ameloblastoma grows in average 40.4% per year (range: 14.9-88.7%). Conclusions Ameloblastoma is a progressively growing tumor, but its growth rate seems to be smaller than initially reported in the literature. Better understanding the radiographic progression of ameloblastoma might improve its early diagnosis, management, and prognosis. Key words: Ameloblastoma, odontogenic tumors, growth rate, panoramic radiograph.

Clinicoradiologic features of ameloblastomas: A single‐centre study of 155 cases

“…The higher frequency of multilocular lesions in adults could be a factor of time, supported by the increased mean age and duration seen in multilocular cases. The progression of cases from unilocular to multilocular lesions has been reported in the literature 29,30 . This might be explained by the cystic degradation of tumour islands being initially too small to detect on imaging.…”

“…The progression of cases from unilocular to multilocular lesions has been reported in the literature. 29,30 This might be explained by the cystic degradation of tumour islands being initially too small to detect on imaging.…”

Growth rate per year of a soft tissue recurrent ameloblastoma

“…Few reports in the literature attempted to evaluate the growth rate of ameloblastoma. Mariz et al 1 used the ImageJ software to estimate the tumor growth rate through the area measurement of matching radiographs of ameloblastomas firstly underdiagnosed. They found that the tumor grows an average of 40.4% per year (14.9-88.7%).…”

The radiologic progression of ameloblastomas

“…A study by Mariz et al found that the lesions changed from a unilocular to a multilocular appearance in 10 of the 12 patients they examined (83%). 19 …”

“…A study by Mariz et al found that the lesions changed from a unilocular to a multilocular appearance in 10 of the 12 patients they examined (83%). 19 Ameloblastomas commonly cause root resorption, tooth displacement or impaction. 3 These findings were mirrored in the current study.…”