Recurrence of Ameloblastoma on the Right Side of the Mandible: A Case Report

Abstract

Ameloblastoma is a benign, locally invasive epithelial odontogenic tumour occuring in the jaw. Among all types, multicystic ameloblastoma is a locally aggressive lesion and prone to recurrence. Hereby, the authors present a case report of a 23-yearold female with a chief complaint of painful swelling on the right lower third of the face for the past one month. History revealed a gradual increase in size of the swelling, along with intermittent and non radiating pain that worsened during mastication and improved with rest. Patient past history revealed similar swelling in the same region twice, with the first occurring five-yearsago and a recurrence after two years of treatment. Both the episodes were treated with laser ablative surgery and extraction of the affected tooth. The patient presented with recurrent swelling one month ago and underwent an incisional biopsy, which revealed a histopathological diagnosis of unicystic ameloblastoma. Additional investigations, including an occlusal radiograph, orthopantomogram, and Computed Tomography (CT), were performed. Based on the recurrence, clinical examination, and investigations, the present case was diagnosed as unicystic ameloblastoma. It was treated with segmental resection followed by reconstruction of the mandible using a free fibula graft was planned. The prognosis was good, and regular follow-up has been maintained for the last four months, with the patient still under review. The uniqueness of present case lies in the patient’s second decade of life, three episodes of recurrence within five years, and the treatment approach of segmental mandibulectomy with immediate free fibula graft reconstruction. This procedure reduces the risk of recurrence, allows for full rehabilitation within a short period, and minimises the number of surgical procedures.

Keywords

• acanthomatous ameloblastoma
• mixed/solid type
• squamous metaplasia