Efficiency of B-RAF-/MEK-inhibitors in B-RAF mutated Ameloblastoma: Case report and review of literature
Reinhard Büttner,
Sibel Elif Gültekin,
Carina Heydt,
Lucia Nogova,
Sonja Meemboor,
Matthias Kreppel,
Reem Aziz-Heiloun
Affiliations
Reinhard Büttner
Institute of Pathology, Medical Faculty, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany; Corresponding author. Cologne Institute of Pathology, Medical Faculty and University Hospital Cologne, Kerpener Straße 62, D-50937, Cologne, Germany.
Sibel Elif Gültekin
Faculty of Dentistry, Department of Oral Pathology, Gazi University, Emek, 06510, Ankara, Turkey
Carina Heydt
Institute of Pathology, Medical Faculty, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
Lucia Nogova
Clinic of Internal Medicine I, Medical Faculty, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
Sonja Meemboor
Institute of Pathology, Medical Faculty, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
Matthias Kreppel
Clinic of Maxillofacial Surgery, Medical Faculty, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
Reem Aziz-Heiloun
Institute of Pathology, Medical Faculty, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
Background: Ameloblastoma is a benign but locally invasive and aggressive odontogenic tumor harboring activating BRAF V600E mutations in about two thirds of the cases. Case presentation: Neoadjuvant therapy with Dabrafenib and Trametinib was given to a 42-year-old male patient with recurrent ameloblastoma of the right mandible with a BRAF V600E mutation for 18 months. The patient manifested an excellent response to the therapy with remarkable reduction in tumor size from 72.6 mm to 55.9 mm. Histopathologically, the tumor underwent significant degenerative changes with only a few sparse vital residuals revealing 0 % Ki67 proliferative index. Conclusions: Neoadjuvant therapy with BRAF-inhibitors or BRAF-MEK-inhibitors is an effective means to reduce the size of mandibulary ameloblastomas. We propose the consideration of neoadjuvant therapy in future treatment modalities to minimize post-surgical morbidity and facial deformations.
