RESUMO
O ameloblastoma é um tumor odontogênico benigno de origem epitelial, localmente invasivo, de curso lento e que apresenta consideráveis taxas de recidivas. É considerado o tumor odontogênico benigno mais relevante clinicamente, sendo atualmente classificado como "ameloblastoma", "ameloblastoma unicístico", "ameloblastoma periférico ou extraósseo" e "ameloblastoma metastatizante". A variante unicística é a segunda mais prevalente, respondendo por aproximadamente 15% de todos os ameloblastomas, mostrando características singulares especialmente em pacientes mais jovens. Este trabalho tem por finalidade aclarar as características desta variante do ameloblastoma a partir do relato de caso do atendimento de um paciente adulto jovem acometido pelo tumor na mandíbula, abordando os aspectos clínicos, imaginológicos, histopatológicos, terapêuticos e prognósticos envolvidos. Neste caso clínico, o tratamento de escolha para o ameloblastoma unicístico foi, inicialmente, a marsupialização da lesão e posteriormente a enucleação com ostectomia periférica e exodontia dos dentes envolvidos. Esta opção de tratamento demonstrou bons resultados, diminuindo os danos ao paciente quando bem indicada, para isso é essencial um diagnóstico precoce e assertivo associando características clínicas e histopatológicas. O paciente segue em proservação cautelosa, visto que o padrão de proliferação do tipo mural requer uma maior atenção dada a sua maior possibilidade de recidiva
The ameloblastoma is an epithelial benign odontogenic tumor which is locally invasive, slow-growing and presents considerable recidive rates. It is considered the most clinically relevant benign odontogenic tumor, currently being classified as "ameloblastoma", "unicystic ameloblastoma", "peripheral or extraosseous ameloblastoma" and "metastatic ameloblastoma". Unicystic type is the second most prevalent ameloblastoma, occurring in approximately 15% of all ameloblastomas, showing specific characteristics, especially in younger patients. The aim of this study is to clarify the characteristics of this type of ameloblastoma, presenting the case report of a young patient affected by the tumor in the jaw, highlighting clinical, imaginological, histopathological, therapeutic and prognostic aspects involved. In this case, the chosen treatment was, initially, the marsupialization of the lesion and posteriorly the enucleation with peripheral ostectomy and tooth extraction involved. This treatment option has shown good results, decreasing the patients damage when properly indicated, for this, an early and assertive diagnosis is essential, associating clinical and histopathological characteristics. The patient keeps on careful follow-up, since the proliferation pattern of the mural type requires greater attention given its greater possibility of recidive.
RESUMO
Ameloblastoma with granular cell pattern (AGC) is classified as an unusual histological subtype of solid/multicystic ameloblastoma, characterized by granular changes in stellate-like cells located within the inner portion of the epithelial follicles. Studies have revealed that lysosomal overload causes cytoplasmic granularity; however, the mechanism involved remains poorly understood. Here we report on eight cases of granular cell ameloblastoma, in the posterior region of the mandible. The age of the patients included in this case series ranged from 35 -64 years old and 87.5% of cases occurred in non-Caucasians, with a slight gender predilection for men (62.5%). There was no evidence of recurrence, and the majority of the cases were treated with surgical resection (87.5%). All tumors displayed histopathological features consistent with the diagnosis of ameloblastoma with granular cell pattern.