A clinical, radiographic, and histologic review of 73 cases of ameloblastoma in an Indian population

Abstract

Objective: Ameloblastomas in Indians have rarely been studied. The present study was undertaken to retrospectively compare the clinical, radiologic, and histopathologic features of 73 cases of ameloblastoma in Indians.

Method and materials: Biopsy records of 73 histologically diagnosed cases of ameloblastoma over an 18-year period were retrieved and analyzed for age, sex, site distribution, clinical presentation, radiologic features, and histopathology. These cases were also evaluated for recurrence.

Results: Ameloblastoma accounted for 60.3% of all odontogenic tumors in this study, with a mean age of presentation of 30.2 years. A slight male predilection and predominant occurrence in the mandibular molar-ramus area were noted. Radiologically, ameloblastoma presented as either unilocular or multilocular radiolucency, with a significant age difference noted between unilocular and multilocular lesions. Interestingly, findings such as cortical plate expansion, perforation, and involvement of the temporomandibular joint were more frequent in females. The most common histologic type in contrast to other studies was unicystic ameloblastoma followed by follicular and acanthomatous ameloblastoma. Specific correlations between histologic type and age, sex, site, and radiologic features were also observed. Recurrence was seen in 13.3% of patients, predominantly in males, in the molar-ramus area, and the common histologic type was follicular ameloblastoma followed by unicystic ameloblastoma.

Conclusion: The finding of unicystic ameloblastoma being the second most common recurrent variant of ameloblastoma, especially when associated with cyst wall invasion or intramural proliferation, may warrant a more aggressive treatment than traditional enucleation/curettage for this entity to prevent recurrence.