Ameloblastoma uniquístico con patrón plexiforme: revisión de la literatura a propósito de un caso clínico / Unicystic ameloblastoma with a plexiform pattern: literature review regarding a clinical case

En 1827 el médico James William Cusack describió una lesión tumoral expansiva con características clínicas similares al ameloblastoma. Para el 2017 la Organización Mundial de la Salud lo clasificó como un tumor odontogénico benigno de origen epitelial. En la actualidad hemos aceptado la teoría de su etiología asociada con una mutación en el biomarcador BRAF-V600E, donde se presentan claras heterogeneidades extra/intratumorales en el metabolismo de la tumorogénesis; la mutación en BRAF genera cambios en la regulación de la odontogénesis, en conjunto con el gen CDC73 presente en el cromosoma 1 q25-q32, lo que produce un cambio en la proteína parafibromina que inhibe la proliferación celular durante el crecimiento y la división celular, esto afecta en conjunto al gen p53 y su homólogo p63 presentes en el cromosoma 17, por lo que se tiene como resultado la expresión de quistes y tumores dentales como el ameloblastoma. La presente obra muestra el caso clínico de un paciente femenino de 11 años de edad con aumento de volumen en la región submandibular izquierda de 7 × 4 cm, con seis años de evolución; de tal manera que fue diagnosticado con ameloblastoma uniquístico y tratado de forma conservadora mediante enucleación, posteriormente fue valorada anualmente hasta que la paciente cumplió los 18 años de edad (AU)

In 1827, physician James William Cusack described an expansive tumor lesion with clinical characteristics similar to ameloblastoma. For 2017, the World Health Organization classified it as a benign odontogenic tumor of epithelial origin. Currently, we have accepted the theory of its etiology associated with a mutation in the BRAF-V600E biomarker, where there are clear extra/intratumoral heterogeneities in the metabolism of tumorigenesis; the BRAF mutation generates changes in the regulation of odontogenesis, together with the CDC73 gene present on chromosome 1 q25-q32, producing a change in the parafibromin protein that inhibits cell proliferation during cell growth and division, which together it affects the p53 gene and its p63 homolog is present on chromosome 17, resulting in the expression of dental cysts and tumors such as ameloblastoma. This work provides the clinical case of an 11-year-old patient with an increase in volume in the left submandibular region of 7 × 4 cm of 6 years of evolution. Being diagnosed as a unicistic ameloblastoma and treated conservatively by enucleation, it is subsequently evaluated annually until the patient reaches 18 years of age (AU)

Hemimandibulectomía por ameloblastoma multiquístico. A propósito de un caso / Multicystic ameloblastoma hemimandibulectomy. A propos of a case

RESUMEN El ameloblastoma es un tumor odontogénico benigno, localmente agresivo y recidivante, con predilección por la región posterior de la mandíbula. Se caracteriza por su agresividad local con muy baja tendencia a metastizarse. El objetivo fue reportar el caso clínico de un paciente con ameloblastoma multiquístico derecho, tratado a través de hemimandibulectomía. Se presentó un paciente masculino, de 44 años de edad, que refirió aumento de volumen del lado derecho de la mandíbula desde hacía aproximadamente un año, acompañado también de otros síntomas, atendido en el Servicio de Cirugía Maxilofacial del Hospital Militar Principal/Instituto Superior, en Luanda, Angola. Los estudios imagenológicos incluyeron radiografía panorámica y tomografía axial computarizada. El diagnóstico clínico patológico fue de ameloblastoma multiquístico. Este tipo de tumor requiere de un adecuado diagnóstico sobre la base de la presentación clínica, localización, tamaño, edad y tipo histológico; de ahí la importancia de conocer las características clínicas e imagenológicas, pues el tratamiento conlleva gran dificultad (AU).

ABSTRACT Ameloblastoma is a benign odontogenic tumor, locally aggressive and recidivist with predilection for back of the jaw, characterized by local aggressiveness and low tendency to metastasize. The aim was reporting the clinical case of a patient with right multicystic ameloblastoma treated through hemimandibulectomy. We presented a male patient aged 44 years, who referred a volume increase of the jaw right side for around a year, accompanied also by other symptoms; he attended the Maxillofacial Surgery Service of the Main Military Hospital/High Institute of Luanda, in Angola. The image studies included panoramic radiography and computerized axial tomography the clinical pathological diagnosis was multicystic ameloblastoma. This kind of tumor requires an adequate diagnosis based on the clinical presentation, location, size, age and histological kind, therefore the importance of knowing the clinical and image characteristics, because the treatment is very difficult (AU).

Peripheral ameloblastoma of the gingiva

Peripheral Ameloblastoma (PA) is a benign odontogenic tumor, arising from the cell rest of Serres, reduced enamel epithelium and basal cells of the surface epithelium. Peripheral ameloblastoma is a rare odontogenic neoplasm occurring commonly in the mandibular gingiva. PA clinically resembles other peripherally occurring lesions like pyogenic granuloma, peripheral ossifying fibroma, peripheral giant cell granuloma, and squamous papilloma. The recurrence rate of PA is 16-19% which demands a straight follow up. We report a case of recurrent peripheral ameloblastoma occurring in a 72-year old male located in the mandibular lingual gingiva in relation to the 44, 45 element's regions. The patient had a primary lesion excised from the same site 6 years before which was diagnosed as ameloblastoma.

Extenso ameloblastoma unicístico em mandíbula: relato de caso / Extensive unicystic ameloblastoma in the mandible: case report

Objetivo: relatar um caso de ameloblastoma unicístico em região anterior de mandíbula, descrevendo os métodos diagnósticos utilizados e o tratamento empregado. Relato de caso: paciente do gênero feminino, com 40 anos de idade, compareceu ao serviço de Cirurgia e Traumatologia Bucomaxilofacial da Faculdade de Odontologia da Universidade Federal da Bahia, com queixas de aumento de volume em região anterior de mandíbula, com evolução de 10 meses. O exame de imagem revelou lesão unilocular extensa que expandia cortical óssea em região de mento. Optou-se pela biópsia excisional da lesão, sob anestesia geral. O exame do espécime obtido confirmou o diagnóstico de ameloblastoma unicístico, para o qual se decidiu pela manutenção da terapêutica inicial. A paciente segue em acompanhamento pela equipe, sem sinais de recidivas. Considerações finais: o manejo do ameloblastoma unicístico, por vezes, demanda a biópsia excisional da lesão, a fim de diferenciá-la dos cistos odontogênicos e de individualizar seu padrão histológico. A abordagem conservadora pode ser adotada, desde que um acompanhamento rigoroso seja procedido. (AU)

Objective: to report a case of unicystic ameloblastoma in the anterior region of the mandible, describing the diagnostic methods used and the treatment applied. Case report: a 40-year-old female patient attended the Oral and Maxillofacial Surgery and Traumatology Service of the School of Dentistry at the Federal University of Bahia, Brazil, complaining of increased volume in the anterior region of the mandible, with a 10-month evolution. Imaging tests revealed extensive unilocular lesion that expanded the cortical bone in the mental region. Excisional biopsy of the lesion was performed under general anesthesia. The examination of the specimen obtained confirmed the diagnosis of unicystic ameloblastoma, for which it was decided to maintain the initial therapy. The patient is still being followed-up by the team, with no signs of relapses. Final considerations: the management of unicystic ameloblastoma sometimes requires excisional biopsy of the lesion to differentiate it from odontogenic cysts and isolate its histological pattern. The conservative approach may be adopted if along with strict monitoring. (AU)

Malignant ameloblastoma: a challenging diagnosis

Ameloblastoma is an uncommon and locally aggressive, benign, odontogenic tumor, with local recurrence when not adequately excised. A rare variant of this neoplasm with the benign features but accompanied with metastases has been described. This rare variant is malignant ameloblastoma and is known to have a poor prognosis. We present the case of a young woman who had recurrent mandibular tumors, which were resected twice and histologically reported as ameloblastoma. Four years later, she presented with pulmonary metastasis and atelectasis. A review of the literature on this very rare neoplasm was also performed.

Ameloblastoma sólido multiquístico en mandibula y reconstrucción con placa de titanio / Solid multicystic ameloblastoma in jaw and reconstruction with titanium plate

El ameloblastoma sólido multiquístico es una neoplasia odontogénica rara, representa el 1% de los tumoresmaxilares, es de crecimiento lento y muestra un comportamiento agresivo local; en estado avanzado es capaz de generar deformidad facial, dolor, infección de la lesión, ulceración de la mucosa, pérdida dentaria, parestesia y puede alterar la masticación y la fonética. Objetivo: determinar las características clínicas, imagenológicas e histológicas del ameloblastoma para realizar el diagnóstico correcto y tratamiento oportuno. Presentación de caso clínico: p aciente femenina de 66 años, tratada en el servicio de cirugía oral y maxilofacial del Hospital Escuela Universitario, por presentar lesión de aspecto tumoral en cavidad bucal y región mandibular izquierda de 4 años de evolución. Los resultados deexámenes complementarios confirmaron que se trataba de un ameloblastoma sólido multiquístico. Se extirpó el tumor con amplios márgenes de seguridad mediante hemimandibulectomía y reconstrucción posterior con placa de titanio 2.4 W Lorenz. Conclusión: Los ameloblastomas son neoplasias benignas que presentan comportamientos clínicos similares con debe establecer un diagnóstico diferencial exhaustivo, auxiliándose de los exámenes complementarios pertinentes para iniciar el tratamiento adecuado y oportuno...(AU)

Les améloblastomes des maxillaires au centre hopsitalier universitaire d'odontosmatologie de Bamako

Introduction: L'objectif de cette étude était, d'évaluer les aspects sociodémographiques, cliniques, anatomopathologiques et thérapeutiques, des patients présentant des améloblastomes des maxillaires, au Centre Hospitalier Universitaire d'Odonto Stomatologie (CHU OS) de Bamako. Matériels et Méthode : Nous avons réalisé une étude rétrospective et prospective sur une période de trois ans (de Janvier 2007 à Décembre 2010), sur des cas d'améloblastomes des maxillaires, confirmés par un examen clinique, associé ou à la radiologie, ou à l'anatomopathologie. Les données ont été recueillies à partir des dossiers médicaux, saisies et analysées avec le logiciel Epiinfo. Résultats : Les lésions tumorales ont concerné 55 hommes et 43 femmes avec un sex-ratio de 1,27. Les femmes au foyer ont été les plus représentées soit 35,7% des cas. La radiographie des maxillaires a été effectuée chez 96% des patients et la biopsie dans 66,3% des cas. La localisation anatomique la plus fréquente a été mandibulaire dans 89,80% des cas, et la zone de prédilection a été la symphyse mandibulaire dans 34,7% des cas. La chirurgie conservatrice a été réalisée chez 50% des patients et la chirurgie radicale dans 26,5% des cas. Conclusion : Cette étude montre une fréquence élevée de l'améloblastome des maxillaires, et un intérêt capital pour une prise en charge précoce, dans un souci de minimiser les récidives

Ameloblastoma maxilar superior: presentación de caso clínico / Upper maxillary ameloblastoma: report of a clinical case

El ameloblastoma es una entidad patológica benigna de origen odontogénico, de alta agresividad local, lo que ha sido un punto de controversia en la literatura científica. Se presenta un caso clínico, con ubicación en maxilar superior con diagnóstico de ameloblastoma sólido multiquístico. Se evalúa el caso, su posibilidad de tratamiento, revisando las características clínicas y anatomopatológicas de laentidad, basándose en una búsqueda bibliográfica.

Ameloblastoma is a benign pathological entity of odontogenic origin, very aggressive at a local level, which has become a controversial issuein cientific literature. A clinic case is presented, located in the superior maxilla diagnosed as a solid multicystic ameloblastoma. The case isevaluated, its ways of treatment, the clinical and anatomopathological characteristics of the entity with an intensive bibliographical researc.

Ameloblastoma uniquístico plexiforme: a propósito de un caso / Plexiform unicystic ameloblastoma: a propos of a case

El ameloblastoma es un tumor odontogénico benigno de origen epitelialcon estroma fi broso maduro sin ectomesénquima odontogénico, decomportamiento localmente agresivo e infi ltrante con alta capacidad de recidiva. Representa entre 11 y 13 por ciento de los tumores odontogénicosmandibulares y 1 por ciento de los tumores y quistes maxilomandibulares. El tratamiento debe orientarse de acuerdo con el potencial del tumor,las características del crecimiento según su variable clínica y el tipo histológico. Debe ser un tratamiento que asegure un mejor pronóstico para el paciente

The ameloblastoma is a benign odontogenic tumor of epithelial origin with mature fi brous stroma, without odontogenic ectomesenchyme. It exhibits locally aggressive and invasive behavior, with a high level of recurrence. Ameloblastomata account for between 11 and 13% of mandibular odontogenic tumors, and 1% of maxillo-mandibular tumors and cysts. Treatment should be guided by the potential of the tumor and its growth characteristics based on the clinical variable and histological type, the preferred treatment being that which ensures the best prognosis for the patient.

Adenomatoid Odontogenic Tumor: A Case Report.

Adenomatoid odontogenic tumor (AOT) is a very rare odontogenic tumor with an incidence of 1%. Overall it accounts for 9% of all odontogenic tumors. In most of the cases, AOT is misdiagnosed as an odontogenic cyst. Younger individuals are commonly affected and particularly in females. AOT is seen predominantly in the maxillary anterior region in association with an unerupted tooth. Permanent dentition is affected more than the deciduous dentition. Intraoral periapical radiographs play a major role in the diagnosis compared to orthopantomogram because of its increased contrast but for the better assessment of the extension of larger lesions orthopantomogram is must. AOT resembles benign odontogenic lesions like dentigerous cyst and tumors like ameloblastoma. The lesions are managed conservatively by surgical excision along with the removal of the affected tooth and have an excellent prognosis.With this background, we report an unusual case of AOT involving maxillary anterior region in 15-year-old male patient. The present article reviews the etiology, clinical features, histopathological features, and treatment modalities of AOT.

Management of Large Mandibular Ameloblastoma Crossing Midline: Reconstructed by Bilateral Iliac Crest Graft: A Rare Entity.

Ameloblastoma is a true neoplasm of odontogenic epithelial origin. It is the second most common odontogenic neoplasm. It’s incidence approximately 1% of all oral tumors and 18% of all odontogenic tumors. More than 80% of cases of ameloblastoma occur in mandible. The ameloblastoma occurs in three variants solid or multicystic, unicystic, and peripheral. A painless expansion of the jaws is the most common clinical presentation. The correct diagnosis can be easily made with the help of plain X-rays and tissue biopsy. The standard management of ameloblastoma is marginal resection but sometimes a large tumor requires complete resection of affected part. Untreated tumors may lead to tremendous facial disfigurement, a severe malocclusion and pathological fractures of the jaw. Here we present a case of a young man with the chief complaint of facial asymmetry. The orthopantomogram of the patient was showing a multilocular radiolucency with Buccal and lingual cortical expansion. A diagnosis was made on the basis of the biopsy as multicystic ameloblastoma, and resection of the mandible was carried out. The mandibular primary reconstruction was done with avascular bilateral iliac crest bone graft. Long term prognosis showed satisfactory healing and good facial esthetics.

Intraluminal Plexiform Unicystic Ameloblastoma: A Report of a Rarity in an 8-year-old Boy.

Unicystic ameloblastoma (UA) is a variant of ameloblastoma and this entity is more common in second to third decade of life. It is very rare in children with <2.2% under the age of 10 years. Th is odontogenic tumor is most commonly encountered in the posterior mandible and is associated with an impacted tooth. Th e term plexiform UA refers to a pattern of epithelial proliferation that has been described in cystic lesions of the jaws. Here is a report of a rare case of intraluminal plexiform UA, in the right posterior mandible of an 8-year-old boy presented to our department.

Aneurysmal Bone Cyst of Mandible: A Case Report.

Aneurysmal bone cysts are rare benign lesions of bone tissue, infrequent in the craniofacial skeleton about other structures like long bones or the spine. The rare jaw lesions encountered in the mandible and maxilla. On the other side, it is at the same time very exciting in terms of its differential diagnosis with other types of mandibular or maxillary bone lesions. We present the case of a 45-year-old female patient with an aneurysmatic cyst located at the left angle of the mandible describing the treatment for the same i.e. surgical excision and hemi mandibulectomy with reconstruction. We have focused on the differential diagnosis, mainly with the malignancies, which can be found at this location, along with therapeutic options classically described for these kinds of pathologies. In our patient, the surgical excision and hemi mandibulectomy allowed a complete removal of the lesion and recon plate was placed for rehabilitation.

Ameloblastoma desmoplásico: revisão de literatura / Desmoplastic ameloblastoma: review of the literature

O ameloblastoma desmoplásico é uma variante dos ameloblastomas e caracteriza-se por estroma densamente colagenizado e permeado por pequenas ilhas e cordões de epitélio tumoral odontogênico com pouca tendência para formar estruturas císticas. Clinicamente apresenta-se como um aumento volumétrico facial indolor localizado predominantemente na região anterior da mandíbula; possui pequena predileção pelo sexo masculino e baixa incidência entre os tumores odontogênicos. Radiograficamente é descrito como uma lesão radiolúcida de limites pouco nítidos, semelhante a bolhas de sabão e que pode mimetizar lesões fibro-ósseas. Reabsorção radicular e neoformação óssea podem estar presentes. A tomografia computadorizada e a ressonância magnética nuclear são exames de imagem úteis para o planejamento do tratamento, principalmente devido às margens mal definidas da neoplasia. O tratamento é controverso, mas a maioria dos autores corrobora a necessidade de excisão com adequada margem de tecidos não envolvidos devido ao alto índice de recidivas. Assim, esse trabalho teve como propósito revisar a literatura pertinente ressaltando as especificidades dessa lesão rara. De acordo com a literatura consultada pudemos concluir que as particularidades dessa variedade de ameloblastoma devem ser conhecidas e que, apesar da controvérsia, o tratamento mais seguro ainda é a ressecção com margens de aproximademente 1 cm...

The desmoplastic ameloblastoma is a variant of ameloblastomas and is characterized by densely collagenized stroma and permeated by small islands and strands of odontogenic tumor epithelium with little tendency to form cystic structures. Clinically presents as a painless facial volumetric increase localized predominantly in the anterior mandible; there is a little preference for male and low incidence among odontogenic tumors. Is described radiographically as a radiolucent lesion with ill-defined borders, similar to soap bubbles and can mimic fibro-osseous lesions. Root resorption and bone formation may be present. Computed tomography and magnetic resonance are useful exams for treatment planning, especially due to ill-defined margins of the neoplasm. Treatment is controversial, but most authors corroborates the need for excision with adequate margin of uninvolved tissue due to the high rate of recurrence. Thus, this work aimed to review the literature emphasizing the specifics of this rare lesion. According to the literature we concluded that the characteristics of this variety of ameloblastoma should be known and that despite the controversy, the safest treatment still is the resection with margins of approximately 1 cm...

Avaliação da expressão imuno-histoquímica das proteínas p53 e pRB em ameloblastomas e tumores odontogênicos queratocísticos / Evaluation of immunohistochemistry expression of the proteins p53 and pRB in ameloblastomas and keratocystic odontogenic tumorP

Tumores odontogênicos constituem grupo abrangente de afecções tumorais, sendo ameloblastomas e tumores odontogênicos queratocísticos as lesões benignas de maior frequência, cujas características biológicas são pouco conhecidas. Objetivo do presente estudo foi avaliar o perfil imuno-histoquímico das proteínas pRB e p53 em ameloblastoma e tumor odontogênico queratocístico. Foram avaliadas amostras de material parafinado de 21 casos de ameloblastoma e de 20 casos de tumor odontogênico queratocístico para ensaio de imuno-histoquímica com os anticorpos anti-pRB e anti-p53. A contagem da imuno-marcação foi realizada a partir de fotografias de alta resolução processadas no software ImageJ para quantificação manual em campo de 1000 células. A localização da imuno-marcação para ambos anticorpos foi semelhante, sendo em ameloblastomas predominantemente nas células da periferia e, em tumores odontogênicos queratocísticos, nas camadas suprabasais. Quantitativamente, as porcentagens de células marcadas foram estatisticamente maior nos ameloblastoma para anti-p53 (p=0,01) e maior nos tumores odontogênicos queratocísticos para anti-pRB (p=0,04). Não houve correlação estatística entre a porcentagem de células marcadas para anti-p53 e anti-pRB nos ameloblastomas, porém, esta correlação foi positiva e moderada nos tumores odontogênicos queratocísticos (r=0,537; p=0,018). Nota-se ligeira diferença na quantificação das imuno-marcações para o anti-p53 e anti-pRB. Tais resultados devem ser ponderados pela reduzida casuística, porém, sugerem perfis distintos em mecanismos biológicos determinantes para ambos os tumores.

Odontogenic tumors are a comprehensive group of tumor diseases, being ameloblastomas and keratocystic odontogenic tumors the most frequent benign odontogenic tumors. Their biological characteristics are little unknown. The aim of present study was to evaluate the immunohistochemical profile of pRB and p53 proteins in 21 cases of ameloblastomas and 20 cases of keratocystic odontogenic tumors for anti-pRB and anti-p53 antibodies. The quantification of immunostaining was performed manually with high-resolution photographs processed in the ImageJ software to quantify positive cells in a 1000 cells-field. The location of immunostaining for both antibodies was similar. In ameloblastomas, positive cells are located mainly in the peripheral layers, whereas in keratocystic odontogenic tumors the positive cells are located in the suprabasal layers. Quantitatively, the percentage of labeled cells was statistically higher in ameloblastomas for anti-p53 (p = 0.01) and higher in keratocystic odontogenic tumors for anti-pRB (p = 0.04). There was no statistical correlation between the percentage of labeled cells to anti-p53 and anti-pRB in ameloblastomas, however, its correlation was positive and moderate in keratocystic odontogenic tumors (r = 0.537; p = 0.018). It is possible to identify a slight difference in immuno-quantification for anti-p53 and anti-pRB among these lesions. These results must be pondered by the small sample, however, is suggests a different profile in a preponderant key biological mechanisms for odontogenic tumors.

Estudo clinicopatológico retrospectivo dos casos de tumores odontogênicos diagnosticados no Serviço de Patologia Cirúrgica da FOUSP no período de 1957 a 2012 / Retrospective clinicopathological study of cases of odontogenic tumors diagnosed in the FOUSP Surgical Pathology Service in 1957 and 2012

Os tumores odontogênicos formam um grupo complexo de lesões, de comportamento clínico variado e encontrado exclusivamente na região bucomaxilofacial. Originam-se a partir das células que normalmente teriam a função de formar o dente, processo esse denominado odontogênese, que tem seu início entre a sexta e a sétima semanas de vida intrauterina. O objetivo deste trabalho foi realizar um estudo clinicopatológico de tumores odontogênicos diagnosticados no Serviço de Patologia Cirúrgica da Faculdade de Oodontologia da Universidade de São Paulo de 1957 a 2012. Foram compilados das fichas de requisição de exames e/ou prontuários dados referentes ao sexo, idade no momento do diagnóstico, cor da pele (branca, negra, ou outras), sintomatologia, tamanho da lesão, duração, localização anatômica, aspectos radiográficos, diagnóstico clínico e histopatológico. Os casos diagnosticados como tumores odontogênicos foram revisados, por um examinador previamente calibrado, com o objetivo de reclassificação das lesões conforme proposição atual da Organização Mundial da Saúde em 2005. Todos os dados obtidos foram inseridos e tabulados no Microsoft Office Excel 2013 e analisados no software BioEstat 5.0. Medidas de frequência central e de dispersão foram obtidas e os resultados apresentados em forma de tabelas e gráficos. Na análise estatística, foi empregado o teste Z de duas proporções com nível de significância de 5%. No período compreendido de 01 de janeiro de 1957 a 31 de dezembro de 2012, foram diagnosticados 2.114 casos de tumores odontogênicos.

Do total de casos diagnosticados, 75 casos foram retirados da análise, pois representavam a mesma lesão em diferentes momentos. Portanto, 2.039 casos de tumores odontogênicos foram incluídos e, após revisão dos casos e reclassificação diagnóstica dos tumores odontogênicos, os 2.039 casos foram agrupados em 16 tipos histológicos diferentes, entre os quais 2.029 (99,51%) eram benignos e 10 (0,49%) malignos. De uma maneira geral, os tumores odontogênicos afetam pacientes na segunda e terceira décadas de vida, sem predileção por sexo, apresentam-se menores do que 1cm de diâmetro e são diagnosticados, em média, 2 anos após seu surgimento. A maioria das lesões acometem a região posterior da mandíbula, com exceção do odontoma e tumor odontogênico adenomatóide, e apresentam aspecto radiográfico radiolúcido inespecífico, o que dificulta um diagnóstico preciso sem a avaliação anatomopatológica.

Odontogenic tumors are a complex group of lesions, varied clinical behavior and found exclusively in the oral and maxillofacial region. Originate from cells that would normally have the function of forming the tooth, a process called odontogenesis, which begins between the sixth and seventh weeks of intrauterine life. The aim of this study was a clinicopathological study of odontogenic tumors diagnosed in Surgical Pathology Service of Oodontologia of the University of São Paulo from 1957 to 2012 were compiled from surveys of request forms and / or records data on gender, age at diagnosis, skin color (white, black, or other), symptoms, lesion size, duration, anatomic location, radiographic findings, clinical and histopathological diagnosis. The cases diagnosed as odontogenic tumors were reviewed by a calibrated examiner, in order to reclassify injuries as current proposition of the World Health Organization in 2005. All data were entered and tabulated in Microsoft Office Excel 2013 and analyzed in software BioEstat 5.0. Central frequency and dispersion measurements were obtained and the results presented in tables and graphs. In the statistical analysis, we used the Z test for similar proportions with 5% significance level. In the period of January 1, 1957 to December 31, 2012 were diagnosed 2,114 cases of odontogenic tumors. Of all diagnosed cases, 75 cases

were removed from the analysis because they represented the same injury at different times. Therefore, 2,039 odontogenic tumors were included and, after review of the cases and diagnostic reclassification of odontogenic tumors, 2,039 cases were grouped into 16 different histological types, including 2 029 (99.51%) were benign and 10 (0, 49%) malignant. In general, the odontogenic tumors affect patients in the second and third decades of life, with no gender preference, are presented less than 1cm in diameter and are diagnosed on average two years after its inception. Most injuries involve the posterior mandible, except for the odontoma and adenomatoid odontogenic tumor, and feature radiolucent radiological findings nonspecific, which hinders accurate diagnosis without pathological assessment.

Reporte de caso: ameloblastoma multiquistico folicular, variante acantomatoso en cuerpo mandibular / Case report:: follicular multicystic ameloblastoma, acanthomatous variationina mandibular body

El ameloblastoma corresponde a una neoplasia poco frecuente, odontogenica, benigna, de carácter local invasivo. Requiere un adecuado diagnóstico en base a la presentación clínica, localización, tamaño, edad y tipo histológico; ya que el tratamiento conlleva gran dificultad. La tasa de recidiva es alta. Se presenta el caso de una paciente femenina adulta, con diagnóstico de ameloblastoma folicular multiquistico acantomatoso localizado en cuerpo de mandíbula sometido a curetaje ante la negativa de resección segmentaria. En control de 6 meses no presentó recidiva.

Ameloblastoma is a rare neoplasia of odontogenic tissue, benign in nature and locally invasive. It requires an appropriate diagnosis based on the clinical presentation, location, size of the lesion, age and histological type, treatment is very difficult, and recurrence being is high. We present the case of an adult female patient, with a diagnosed follicular multicystic ameloblastoma, acanthomatous, located in the mandible body, which was treated with curettage due to refusal of local segmental resection. Six months later, no recurrence was present.

Calretinin expression in the differential diagnosis of ameloblastoma and keratocystic odontogenic tumour

To determine calretinin expression by immunohistochernistry in ameloblastoma and keratocystic odontogenic tumors [KCOT] and to document the use of calretinin as a differentiating marker between the two lesions. A cross sectional study conducted on previously diagnosed cases of ameloblastoma and Keratocystic odontogenic tumour. Armed forces Institute of Pathology, Rawalpindi Pakistan and duration was one year. [Sep 2009 - Aug 2010]. Twenty cases each of Ameloblastoma and KCOT were retrieved from the record files along with their paraffin embedded blocks. Histological features of all the cases were reviewed on freshly prepared slides and a fresh diagnosis made regardless of the previous diagnosis. The immunohistochemical marker, Calretinin, was applied on both types of cases using the avidin-biotinylated peroxidase complex method.The results were interpreted. In the cases of Ameloblastoma the epithelial tumour nests showed positivity for Calretinin expression. In 85% cases; intense and diffuse staining was observed in more than 80% of the stellate reticulum like cells while 15% cases showed focal and moderate staining patterns. On the other hand KCOT showed contrary results as none of epithelial lining expressed positive staining for Calretinin, [p<0.001]. Calretinin can be used as a useful marker for Ameloblastoma and can be used to differentiate KCOT from Ameloblastoma

Evaluación mediante radiología, tomografía computarizada y resonancia magnética de un ameloblastoma sólido. Reporte de un caso / Evaluation of a solid ameloblastoma using radiology, computed tomography and magnetic resonance imaging. A case report

De acuerdo con la Organización Mundial de la Salud (OMS), el ameloblastoma es un tumor odontogénico benigno, siendo una de sus variantes intraóseas más frecuentes el ameloblastoma sólido o multiquístico, el cual tiene un comportamiento local agresivo por su capacidad de alcanzar grandes dimensiones y desplazar estructuras anatómicas vecinas. Se reporta el caso de un paciente masculino que presentaba un ameloblastoma sólido en la mandíbula, de 7 años de evolución, que producía marcada asimetría facial y limitación de la función de la zona anatómica afectada. Debido a las dimensiones de la lesión, se utilizaron diversas técnicas imaginológicas con la finalidad de contribuir en el diagnóstico, determinar la extensión de la lesión y planificar el tratamiento. Se presenta una revisión de la literatura sobre tomografía computarizada (TC) e imagen por resonancia magnética (IRM) del ameloblastoma, cuyo objetivo es contribuir a definir sus características imaginológicas. Se enfatiza la importancia de estas técnicas de imagen modernas en el proceso de diagnóstico, planificación del tratamiento quirúrgico y el seguimiento a largo plazo de esta patología...

According to the World Health Organization (WHO) ameloblastoma is a benign odontogenic tumor. The most frequent intraosseous variety is the solid or multicystic ameloblastoma, which exhibits a locally aggressive behavior due to its potential to reach large dimensions and displace adjacent anatomic structures. We report a case of mandibular solid ameloblastoma in a 33 year old male, with an evolution time of 7 years. The lesion produced marked facial asymmetry as well as functional limitations of the involved anatomical areas. Given the dimensions of the tumor, proper imaging techniques were used to assist the diagnosis, determine the extent of the lesion and guide treatment planning. A review of the literature regarding the characteristics of the solid ameloblastoma in computed tomography and magnetic resonance imaging is presented in order to better understand its imaging features. The value of these modern imaging techniques in diagnosis, surgical treatment planning and the long term follow up of this lesion is emphasized...