Uniquistic ameloblastoma in dentigerous cyst.
Diagnostic difficulties. Presentation of a case and review of the literature.
Introduction: Unicystic ameloblastoma (AU) is a clinicopathological variant of ameloblastoma with clinical and radiographic characteristics indistinguishable from other cystic lesions, usually benign, affects a younger age group. The cystic lining of unicystic ameloblastoma is not always uniform, and may consist focally of a non-specific epithelium or another similar to that of other odontogenic cysts. This variability in the histological presentation reinforces the importance of adequate sampling in these cystic lesions that allow arriving at the correct diagnosis.
Presentation of the case: the purpose of this work is to present a case of a 14-year-old male patient who consulted for a non-painful right facial bulge of more than two years of evolution, without signs of phlogosis. Radiographically, an intraosseous osteolytic image was observed, with cortical thinning, with a tooth included, with a presumptive diagnosis of odontogenic cyst. An incisional biopsy and puncture aspiration were performed, arriving at the diagnosis of a dentigerous cyst with ameloblastomatous transformation. Complete removal of the lesion was performed with safety margins and bone grafting. The definitive diagnosis was Mural Unicystic Ameloblastoma. The evolution was favorable with regular controls every 3 months for more than a year.
Conclusion: We emphasize the relevance of knowing its characteristics and sampling for the correct histopathological diagnosis that determines subsequent therapeutic management.
Keywords: odontogenic tumors, odontogenic cyst histopathology; Unicystic ameloblastomas.
How to Cite
License
Copyright (c) 2023 Revista Nacional de Odontología
This work is licensed under a Creative Commons Attribution 4.0 International License.
Every single author of the articles has to declare that is an original unpublished work exclusively created by them, that it has not been submitted for simultaneous evaluation by another publication and that there is no impediment of any kind for concession of the rights provided for in the contract.
In this sense, the authors committed to await the result of the evaluation by the journal Revista Nacional de Odontologia before considering its submission to another medium; in case the response by that publication is positive, additionally, the authors committed to respond for any action involving claims, plagiarism or any other kind of claim that could be made by third parties.
At the same time, the authors have to declare that they are completely in agreement with the conditions presented in their work and that they cede all patrimonial rights. These rights involve reproduction, public communication, distribution, dissemination, transformation, making it available and all forms of exploitation of the work using any medium or procedure, during the term of the legal protection of the work and in every country in the world, to the Universidad Cooperativa de Colombia Press.
Churchill H. R. Histological Differentiation between Certain Dentigerous Cysts and Ameloblastomata. Dent Cosmos. 1934; Nov 76 (11): 1173-1178.
Masthan K. M. K., Anitha N., Krupaa J., Manikkam S. Ameloblastoma. J. Pharm Bioallied Sci. 2015; 7 (Suppl 1): S167-S170.
Vered M, Wright JM. Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Odontogenic and Maxillofacial Bone Tumours. Head Neck Pathol. 2022 Mar;16(1):63-75. doi: 10.1007/s12105-021-01404-7. Epub 2022 Mar 21. PMID: 35312978; PMCID: PMC9019005.
Regezi J., Sciubba J., Jordan R. Oral Pathology: Clinical Pathologic Correlations. 6 Ed. St Louis, Missouri: Elsevier; 2012.
Kalmegh PP, Hande AH, Gawande MN, Patil SK, Sonone AM. Unicystic Ameloblastoma (UA): A Case Series. Cureus. 2022 Nov 3;14(11):e31039. doi: https://doi.org/10.7759/cureus.31039 PMID: 36475180; PMCID: PMC9719033.
Philipsen HP, Reichart PA. Odontogenic tumors, and allied lesions. Quintessence books; London Pub 2004; pp. 77–86.
Reichart PA, Philipsen HP, Sonner S. Ameloblastoma: biological profile of 3677 cases. Oral Oncol Eur J Cancer 1995; 31B:86-99.
Robinson L., Martinez M. Unicytic Ameloblastoma A prognostically Distinct Entity. Cancer. 1977; 40: 2278-2285.
Cadavid AMH, Araujo JP, Coutinho-Camillo CM et al. Ameloblastomas: current aspects of the new WHO classification in an analysis of 136 cases. Surg Exp Pathol. 2019;2(1):17. doi: https://doi.org/10.1186/s42047-019-0041-z
Arora S. Unicystic Ameloblastoma: A Perception for the Cautious Interpretation of Radiographic and Histological Findings. J Coll Physicians Surg Pak. 2015 Oct;25(10):761764-764. doi: https://doi.org/10.2015/JCPSP.761764 PMID: 26454399.
Ackerman GL,Altini M. Shear M. The unicystic ameloblastoma: a clinicopathological study of 57 cases. J.Oral Pathol.1988;17:541-546
Leider AS, Eversole LR, Barkin ME. Cystic ameloblastoma. A clinicopathologic analysis. Oral Surg 1985; 60:624-30.
Li TJ. Browne RM, Matthews JB. Expression of proliferating cell nuclear antigen (PCNA) and Ki-67 in unicytic ameloblastoma. Histopathology. 1995; 26:219.228
Vickers RA, GorlinRJ..Ameloblastoma: delineation of early histopathological features of neoplasia. Cancer 1970;26:699.
Lawal A. O., Adisa A. O., Olajide M. A. Cystic Ameloblastoma: A clinico-pathologic review. Ann Ib Postgrad Med. 2014; 12(1):49-53.
Singh A., Shaikh S., Samadi F. M., Shrivastava S., Verma R. Maxillary unicystic ameloblastoma: A review of the literature. Natl J. Maxillofac Surg. 2011; 2(2):163-168.
Cawson RA. Edward WO. Fundamentos de medicina y patología oral. (9na Ed). Elselvier. 2014. p. 164-170.
Meshram M, Sagarka L, Dhuvad J, Anchlia S, Vyas S, Shah H. Conservative Management of Unicystic Ameloblastoma in Young Patients: A Prospective Single-Center Trial and Review of Literature. Journal of maxilofacial and oral surgery. 2017;16(3):333–341. doi: https://doi.org/10.1007/s12663-016-0987-2
Kuda Singappulige Niluka Darshani Gunawardhana, Primali Rukmal Jayasooriya Wanninayake Mudiyanselage Tilakaratne. Dilema diagnóstico del ameloblastoma uniquístico: nuevos parámetros para diferenciar el ameloblastoma uniquístico de los quistes odontogénicos comunes. Journal of Investigative and Clinical Dentistry. 2014; 5(3);220-225. doi: https://doi.org/10.1111/jicd.12071.
Ruiz-Imbert, Ana Cecilia; Calderón-Ubaqui, Víctor; Delgado-Azañero, Wilson A.; Ruiz García, Vilma Elizabeth; Trevejo-Bocanegra, Ana Paola; Ventura-Ponce, Helard; Huamaní-Parra, Jaime Evaluación mediante radiología, tomografía computarizada y resonancia magnética de un ameloblastoma sólido. Reporte de un caso Rev. Estom. Hered., 2014, 24;(3):178-185.
Sarracent Valdés, Yamina, Gbenou Morgan, Yurián, Franquelo Sarracent, Dailyn. (2017). Manejo de quiste dentígero mandibular de grandes proporciones. Presentación de un caso. Revista Habanera de Ciencias Médicas, 16(4), 604-611.
Hendra FN, Natsir Kalla DS, Van Cann EM, de Vet HCW, Helder MN, Forouzanfar T. Radical vs conservative treatment of intraosseous ameloblastoma: systematic review and meta-analysis. Oral Dis. 2019;25(7):1683-1696. doi: https://doi.org/10.1111/odi.13014
Tovío-Martínez E, Anaya-Guzmán L, Rivera-Peñates D. ¿Quiste dentígero o ameloblastoma? Importancia del análisis histológico en el diagnóstico de estas patologías. Rev. Cient. Odontol. (Lima). 2020;8(3):e034 doi: https://doi.org/10.21142/2523-2754-0803-2020-034
Parul S, Aparna M, Asha K, Chetana C, Sunitha C, Raghu R. Role of Immunomarkers in the Clinicopathological Analysis of Unicystic Ameloblastoma. Dis. Mark. 2002;35(5):481–488. doi: http://dx.doi.org/10.1155/2013/517834
Al-Otaibi O, Khounganian R, Anil S, Rajendran R. •La expresión de superficie Syndecan-1 (CD138) marca el tipo celular y la diferenciación en ameloblastoma, tumor odontogénico queratoquístico y quiste dentígero.. J Oral Pathol Med. 2013; 42 (2):186-93. PMID: 22747594
Pereira NB, Pereira KM, Coura BP, Diniz MG, de Castro WH, Gomes CC, Gomez RS. BRAFV600E mutación en el diagnóstico de ameloblastoma uniquístico. J Oral Pathol Med. 2016;45(10):780-785. doi: https://doi.org/10.1111 / jop.12443. PMID: 27084044
Bilodeau EA, Collins BM Quistes y neoplasias odontogénicas. Surg Pathol Clin. 2017 Mar;10(1):177-222. doi: https://doi.org/10.1016/j.path.2016.10.006. PMID: 28153133.
Takahashi S, Idaira Y, Sato T, Asada Y, Nakagawa Y. Unicystic ameloblastoma in a child treated with a combination of conservative surgery and orthodontic treatment: a case report. J Clin Pediatr Dent. 2019; 43(2):121-5. doi: https://doi.org/10.17796/1053-4625-43.2.9
