Editor's note: Originally published October 2016. Updated January 2024.
Case presentation
A healthy 40-year-old woman presents with a six-year history of a recurrent anterior mandibular swelling. She felt no pain but was ashamed of being seen in public. She had two prior surgeries to correct the original condition. When the lesion was previously removed it was small and asymptomatic. The first surgery was done six years ago and the second surgery two years after that. After the second surgery, the patient decided to pursue herbal treatment because regular treatment wasn’t yielding a definitive result. She returned three years later with no improvement and the current presentation.
Differentials
- Ameloblastoma
- Fibro-osseous lesion
- Fibrous dysplasia
- Ossifying fibroma
Definitive diagnosis
Recurrent ameloblastoma of anterior mandible
Discussion and treatment
Recurrent ameloblastoma is a rare, benign tumor of the odontogenic epithelium occurring much more commonly in the mandible than the maxilla. Although it is rarely malignant or metastatic, it progresses slowly and can cause severe abnormalities of the face and jaws. Ameloblastoma has abnormal cell growth, which easily infiltrates and destroys surrounding bony tissues.
Incidence rates per million for ameloblastoma globally:1
- Black males: 1.97
- Black females: 1.23
- White males: 0.19
- White females: 0.45
Wide surgical intervention is required to effectively treat this condition. A bilateral hemimandibulectomy was done for this particular patient.
Reference
1. Shear M, Singh S. Age-standardized incidence rates of ameloblastoma and dentigerous cysts on the Witwatersrand, South Africa. Community Dent Oral Epidemiology. 1978;6:195-199.
