Pathology
Ameloblastoma of the Jaws: A Retrospective Analysis of 340 Cases in a Malaysian Population

https://doi.org/10.1016/j.joms.2011.02.039Get rights and content

Purpose

Ameloblastoma of the human jaw is an uncommon but clinically significant odontogenic epithelial neoplasm. The aim was to analyze the clinicopathologic characteristics of ameloblastoma in a Malaysian population.

Materials and Methods

This is a retrospective study (1993 through 2008) of consecutive ameloblastoma cases accessioned in 2 main oral pathology diagnostic centers: the Unit of Stomatology, Institute for Medical Research and the Department of Oral Pathology, Oral Medicine, and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia. Data on patient demographics, tumor location, symptomology, duration, radiographic appearance, preoperative diagnosis, clinicopathologic subtypes, treatment, and recurrence were analyzed.

Results

Three hundred forty cases of ameloblastoma were reviewed. These were from 197 male patients (57.9%) and 143 female patients (42.1%), with a male-to-female ratio of 1.4:1. A wide age range (7 to 85 years), mean onset age of 30.3 ± 16.3 years, and peak incidence in the second decade of life were recorded. Most were mandibular tumors (n = 311/340, 91.5%). These consisted of 95 (28%) unicystic ameloblastomas, 221 (65%) solid/multicystic ameloblastomas, 22 (6.4%) desmoplastic ameloblastoma, and 2 (0.6%) peripheral ameloblastomas. Unicystic ameloblastoma (41.1%) and solid/multicystic ameloblastoma (52.0%) mostly affected Malays patients, whereas desmoplastic ameloblastoma (59.1%) was prevalent in Chinese patients. Unicystic ameloblastoma (56.8%) and solid/multicystic ameloblastoma (47.1%) occurred predominantly in the body and posterior mandible, whereas desmoplastic ameloblastoma (36.4%) preferentially involved the anterior jaw segment. Most tumors presented as multilocular radiolucencies (36.8%). Enucleation (n = 42/92, 45.7%) was the treatment of choice. About 18 cases (13.3%) presented with recurrence.

Conclusions

Because ameloblastoma subsets differ in their biologic behavior, the present data are significant as baseline references for clinicians and pathologists.

Section snippets

Materials and Methods

The surgical biopsy records of all histologically diagnosed cases of ameloblastoma archived from January 1993 through December 2008 inclusive were retrieved from the files of the Unit of Stomatology, Institute for Medical Research and the Department of Oral Pathology, Oral Medicine, and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia. This was a retrospective study that was exempted from institutional review board approval (research grant RG83/09HTM). A

Clinical Findings

From the 1,234 cases of odontogenic tumors (excluding keratocystic odontogenic tumors) accessioned over the 16-year study period, 340 histologically confirmed ameloblastomas were analyzed, yielding an incidence of 27.6%. The distribution of these cases according to ethnicity, anatomic location, mean duration, radiologic appearance, and clinicopathologic subtypes are presented in Table 1. Statistical analysis showed significant differences in the distribution of ameloblastoma in relation to

Discussion

In the present study, all 340 cases were classified according to the new 2005 WHO classification.1 A search of the English-language literature disclosed few reports that reviewed large series of ameloblastomas per se9, 10, 11, 12 or odontogenic tumors13, 14, 15, 16 in accordance with the new 2005 WHO classification.1 Recent ameloblastoma review series have included a multicentric Latin-American study on 163 cases of ameloblastoma,9 a critical appraisal of 25 cases from a single institution,10 a

Acknowledgments

The authors thank all clinical specialists at the Ministry of Health, Malaysia, Faculty of Dentistry, University of Malaya and private hospitals/clinics for their case contributions that made this project possible. This study was supported by a grant from the University of Malaya (RG083/09HTM).

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