Case ReportRecurrent ameloblastoma of the anterior skull base: Three cases treated by radical resections
Introduction
Ameloblastoma is a benign but locally invasive epithelial odontogenic tumour. Recurrence is most common after inadequate treatment, with an incidence of up to 90% in the mandible and 100% in the maxilla (Sehdev et al., 1974). In cases of radical resection including adjacent soft tissues, a recurrence rate of 5–15% has been reported (Muller and Slootweg, 1985). A few cases of recurrence have been reported involving the temporal fossa (Hayward, 1991; Demeulemeester et al., 1988; To et al., 2002). In this paper, 3 patients are presented with recurrent ameloblastomas in the anterior skull base (frontotemporal fossa or pterygomaxillary fossa) each of which was treated by radical resection.
Section snippets
Patient 1
In 1997, a 42-year-old woman with right frontotemporal swelling was referred. The patient had a right mandibular ameloblastoma treated by currettage at the ages of 26 and 32, and then a segmental mandibulectomy at the age of 37. Physical examination showed a 5×8 cm hard, well defined mass with right exophthalmos (Fig. 1A). CT scanning showed a large multilocular lesion in the right pterygomaxillary fossa and the skull base involving the orbital region (Figs. 1B,C). The patient underwent removal
Discussion
The problem of recurrence following removal of an ameloblastoma can be attributed to inadequate excision and the spread of residual tumour fragments within adjacent bone (To et al., 2002). In the 3 patients reported, recurrent ameloblastomas spread to the frontotemporal, infratemporal and pterygomaxillary fossae, orbit, and skull base. The ages of the three patients at the time of the first operations were 17, 26, and 38 years respectively (mean 27 years). Two of the primary tumours were
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