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Ameloblastoma of gingiva a case report


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Ameloblastoma of gingiva a case report

  1. 1. ISSN 0975-8437 INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(2):111 -112 CASE REPORTAmeloblastoma of Gingiva - A Case ReportRosaiah Kanaparthy, Aruna KanaparthyAbstract Peripheral ameloblastoma is a rare, but develops in the soft tissues of the gingiva and mucosa andexhibits an innocuous clinical behavior. Th is paper reports a case of peripheral ameloblastoma in a 35-year-o ldfemale that presented as a painless swelling on the mandibular anterior labial attached gingiva . This reportsemphasis the need for submitting all excised tissue for microscopic examination and to include ameloblastoma inthe differential diagnosis a gingival lesion wh ich clin ically resemb les a pyogenic granulo ma, peripheral giantcell granuloma, or parulis/gumboil.Keywords: Ameloblastoma; Odontogenic tumor; gingiva Received on: 28/04/2011 Accepted on: 09/05/2011Introduction Radio logical examination revealed a A meloblastoma is a rather rare tumour mu ltilocular cystic lesion extending fro m the lo weroccurring in the jaws. The first detailed description left central incisor to the first mo lar showingof this lesion was by Falkson in 1879, but the term displaced canine and second premo lar. Extended‘ameloblastoma’ was coined by Churchill in surgical excision of the soft tissue growth fo llo wed1933.(1) It represents approximately one per cent by curettage was carried out and the mass was sentof oral tu mours, with 80 per cent of for h istopathological evaluation. Pathology reportameloblastomas occurring in the mandib le, and showed tumor mass comprising of islands anddevelops fro m the odontogenic epitheliu m and its interdigitating cords lined by ameloblasticderivatives or remnants. So met imes it arises fro m a epithelial cells with benign looking nuclei anddentigerous cyst.(2, 3) Peripheral ameloblastoma, a proliferation of stromal cells in the islands. Foci ofrare and unusual variant of odontogenic tumour, squamous metaplasia were present. The cords andcomprises about 1% of all ameloblastomas.(4) The follicles were separated by loose fibroconnectiveextraosseous location is the peculiar feature of this tissue and the diagnosis was a mixed fo llicu lar andtype of tumour, which is otherwise similar to the plexiform type ameloblastoma (Figure 2).classical ameloblastoma.(5) The best treatment isan initial extended surgical excision.(6) Howeverconservative treatment can lead to a highrecurrence rate of about 90%.(1) This paper reportsa case of peripheral ameloblastoma in a 35-year-old female that presented as a painless swelling onthe mandibular anterior labial attached gingiva.Case Report A 35 year o ld wo man reported in the Fig 2 Histopathological slide showing anastomosis and folliclesOPD o f periodontics with a chief co mp laint of a Discussionpainless swelling of the gums since 6 months. The The peripheral ameloblastoma, alsopatient had a slight asymmetry of the face due to known as the extraosseous ameloblastoma, softthe swelling on the left side. There was no tissue ameloblastoma, ameloblastoma of mucosally mphadenopathy and the patient was in good origin, or ameloblastoma of the gingiva is a veryhealth. Intraoral examination revealed a firm soft uncommon odontogenic tumour. (5, 7, 8) Philipsentissue mass measuring 2.5cmX2cmX1cm in the et al reported that several authors refer to Kuru asbuccal vestibule extending fro m the left lo wer having reported on the peripheral ameloblastomacanine to the second premolar with a slight for the first time in 1911.(5, 7)displacement of the teeth involved (Figure 1). Histologically, it resemb les the intraosseous common ameloblastoma but is limited to the soft tissue of the gingiva. It is believed to arise directly fro m the overlying epitheliu m or fro m the remnants of the dental lamina located in the extraosseous soft tissue.(5, 9) Fig 1 Preoperative view©INT ERNA TIONA L JOURNA L OF D ENT AL CL IN ICS VOLU ME 3 ISS UE 2 APRIL-JUN E 2011 111
  2. 2. ISSN 0975-8437 INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(2):111 -112 Patients have been documented fro m 23 2. Iordanidis S, M akos C, Dimitrakopoulos J, Karikiyears to 82 years of age, and lesions occur on the H. Ameloblastoma of the maxilla. Case report.mandib le twice as often as on the maxilla. There Australian Dental Journal. 1999;44(1):51-5. 3. Shteyer A, Lustmann J, Lewin-Epstein J. The muralwas no difference in location between the left and ameloblastoma: a review of the literature. Journal ofright side of the jaws.(4, 5) Ou r patient was 35 oral surgery.1978;36(11):866-72.years old. The lesion was a 2.5 cm painless, non- 4. Ficarra G, Hansen LS. Peripheral ameloblastoma::ulcerated growth on the buccal attached gingiva of A case report. Journal of Cranio-M axillofacialthe premolars of the left mandibu lar reg ion. The Surgery. 1987;15:110-2.lesion was covered by normal mucosa with a 5. Pekiner F, Ozbayrak S, Sener B, Olgac V,smooth surface. Thus, this lesion is similar to those Sinanoglu A. Peripheral ameloblastoma: a casedescribed in the literature.(4) There was no report. Dentomaxillofacial Radiology. 2007;36 (3):radiological evidence of bone involvement. The 183-6. 6. M athur LK, Bhalodi AP, M anohar B, Bhatia A, Railesions had an inferior marg in that was superficial N, M athur A. Focal fibrous hyperplasia: a caseto the cortical bone. report. International Journal of Dental Clinics. The types of treatment that can been used 2010; 2(4):56-7.include both radical and conservative surgical 7. Philipsen H, Reichart P, Nikai H, Takata T, Kudoexcision, curettage, chemical and electrocautery, Y. Peripheral ameloblastoma: biological profileradiation therapy or a combination of surgery and based on 160 cases from the literature. Oralradiation.(4, 10) In our case the ameloblastoma was Oncology. 2001;37(1):17-27.treated conservatively in february2009 and so far 8. Reddy R, Jain U, US S, Agarwal N. Idiopathicthere has been no recurrence. The prognosis of Gingival Enlargement-An Inter-Disciplinary Approach. International Journal of Dental Clinics.patients afflicted with this form of neoplastic 2011;3(1):92-3.disease is favorable, since it is essentially a local 9. Wettan HL, Patella PA, Freedman PD. Peripheralproblem. ameloblastoma: review of the literature and reportConclusion of recurrence as severe dysplasia. Journal of oral In conclusion this reports emphasis the need and M axillofacial Surgery. 2001;59(7):811-5.for submitting all excised tissue for microscopic 10. M arkose E, M ani V. Ameloloblastic carcinoma-aexamination and to include ameloblastoma in the case report. International Journal of Dental Clinics.differential diagnosis a gingival lesion wh ich 2010;2(4):54-5.clin ically resembles a pyogenic granulo ma, Address for correspondenceperipheral giant cell granuloma, or parulis/gumboil. Dr. Rosaiah Kanaparthy, M DS,Authors Affiliations: 1. Dr. Rosaiah Kanaparthy, M DS, Professor and HOD,Professor and HOD, Dept. of Periodontics, 2. Dr. Aruna Dept. of Periodontics,Kanaparthy, M DS, Senior Lecturer, Conservative Peoples Dental Academy,Dentistry, Peoples Dental Academy , Bhopal, M adhya Bhopal, M adhyapradesh, India.pradesh, India. Ph:+0091.9893050554References Email: medha98@gmail.com1. Larsson Å, Almerén H. Ameloblastoma of the jaws. Acta Pathologica M icrobiologica Scandinavica Section A Pathology. 1978;86(1‐6):337-49. Source of Support: Nil, Conflict of Interest: None Declared©INT ERNA TIONA L JOURNA L OF D ENT AL CL IN ICS VOLU ME 3 ISS UE 2 APRIL-JUN E 2011 112