Imaging Sci Dent.  2019 Sep;49(3):241-249. 10.5624/isd.2019.49.3.241.

Maxillary ameloblastoma in an 8-year-old child: A case report with a review of the literature

• Sheela S
• Singer SR
• Braidy HF
• Alhatem A
• Creanga AG

• KMID: 2458374
• DOI: http://doi.org/10.5624/isd.2019.49.3.241

Abstract

Ameloblastoma is a benign locally invasive tumor with a high tendency to recur. It is considered rare in the pediatric population, with most cases diagnosed in the third to fifth decades of life. Approximately 80% of ameloblastomas occur in the molar and ramus region of the mandible, while 20% of cases occur in the maxillary posterior region. This report presents a case of plexiform ameloblastoma in an uncommon location in an 8-year-old child. The lesion was initially thought to be a dentigerous cyst, based on its location and radiographic appearance. The clinical and radiographic features, histopathology, and treatment of solid, plexiform, maxillary ameloblastoma are reviewed, with an added emphasis on a literature review of ameloblastoma in children. This report emphasize the importance of long-term follow-up, since recurrence may occur many years after initial tumor removal.

Keyword

Ameloblastoma; Child; Cone-Beam Computed Tomography; Maxilla

MeSH Terms

Ameloblastoma*
Child*
Cone-Beam Computed Tomography
Dentigerous Cyst
Follow-Up Studies
Humans
Mandible
Maxilla
Molar
Recurrence

Figure

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  Fig. 1 Panoramic radiograph taken on the first visit. A small oval radiolucency can be observed around the impacted maxillary left lateral incisor.

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  Fig. 2 Cone-beam computed tomography (CBCT) images taken on the first visit. A. CBCT panoramic reconstruction shows a low-density area surrounding the permanent maxillary left central and lateral incisor and causing displacement of the teeth. B. Sagittal CBCT view shows expansion of the buccal and palatal cortices in the anterior maxilla. C. Axial CBCT view at the level of the maxilla. The arrow indicates the impacted maxillary left lateral incisor.

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  Fig. 3 Clinical photographs taken at the time of surgical enucleation. A and B. Impacted maxillary left lateral incisor exposed, bonded, and ligated at the time of the procedure. C. Fragments of the lesion and extracted primary maxillary left lateral incisor and canine.

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  Fig. 4 Hematoxylin and eosin stained sections of the lesion demonstrating cords and sheets of anastomosing odontogenic epithelial cells consistent in appearance with the plexiform variant of ameloblastoma. Note the epithelial cells, which show reverse polarization away from the basement membrane (arrowheads), and the stellate reticulum-like cells and suprabasal cells, which compose loosely arranged angular cells (star). A and B are ×4 magnification fields, C and D are ×10 magnification fields.

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  Fig. 5 Postoperative panoramic radiograph (2014) taken after 1 year shows the maxillary left lateral incisor protruding through the mucosa.

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  Fig. 6 Panoramic radiograph (2015) shows a radiolucency distal to the maxillary left lateral incisor.

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  Fig. 7 Cone-beam computed tomography cross-sectional images show an enlarged periodontal ligament space, missing buccal plate, and bone loss around the maxillary left lateral incisor.

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  Fig. 8 Panoramic radiograph (2017) shows no distinct radiographic evidence of recurrence.

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