Ameloblastoma in Jamaica--predominantly unicystic: analysis of 47 patients over a 16-year period and a case report on re-entry cryosurgery as a new modality of treatment for the prevention of recurrence.

OBJECTIVE: To analyse all the cases of ameloblastoma seen in the two major public Hospitals in Jamaica over a 16-year period, and to compare the results with what has been previously documented by other authors in the literature. A new treatment modality for prevention of recurrence of ameloblastoma is described. SUBJECTS AND METHODS: The case files of patients histologically diagnosed to have ameloblastoma at both the Kingston Public Hospital and Cornwall Regional Hospital in Jamaica from 1980 to 1995 were retrieved and information about this odontogenic tumour was documented. The analysis revealed that uncystic ameloblastoma was predominant (95%) and solid ameloblastoma was about 5%. It was not therefore surprising that the average age in the study was 29.1 years, with a peak in the 10-19-year age group. No peripheral ameloblastoma was diagnosed. RESULTS: A total of 47 new cases of ameloblastoma was recorded between 1980 and 1995. This number accounted for 16.03% of all jaw bone lesions in Jamaica and 38.2% of jaw bone lesions of odontogenic origin during this period. These cases of ameloblastoma accounted for 67% of odontogenic tumours with the exception of the odontomas. The mean age was 29.1 (range 13-67) years. The male:female ratio was 1:1.14). Only 3 cases involved the maxilla. Of significance, is the case of bilateral ameloblastoma with no continuity to the anterior region, and also the case of unilateral involvement of the mandible and the maxilla in the same patient. Re-entry cryosurgery (a procedure in which cryosurgery is done after a specified period from the primary surgical procedure) after excisional biopsy of a relatively small cystic ameloblastoma of the maxilla was negative for recurrence. CONCLUSION: The clinicopathological presentation of ameloblastoma in Jamaica is not different from what has been documented by other authors throughout the world; however; we report two unique cases --a case of bilateral ameloblastoma of the mandible and a case of unilateral involvement of the mandible and maxilla in the same patient. We suggest that re-entry cryosurgery before recurrence be considered in the management of ameloblastoma for the prevention of recurrence.