Papilliferous Keratoameloblastoma: Systematic review

Abstract

Papilliferous keratoameloblastoma (PKA) is a rare entity, and not much is known about its clinicodemographic features or biological nature. This review aimed to provide clarity regarding the characterisation of the demographic, clinical, radiological and histopathological features of PKA. Case reports of PKA were identified through a systematic search across multiple databases. The search yielded a total of 10 cases, half of which were of Indian origin. All the cases invariably occurred in the mandibular posterior region and involved the right side; only one case primarily involved the left side of the mandible. PKA should be considered a variant of the conventional ameloblastoma that is towards the more aggressive end of the spectrum. It tends to occur in older individuals (in their fifth decade or older), with a marked propensity to occur in the right mandibular posterior region. Surgical resection with diligent follow-up is warranted in the treatment of PKA.

Keywords: Ameloblastoma; Keratin; Odontogenic Keratocyst; Odontogenic Tumors.

Figure 1

PRISMA flow chart showing the selection process of articles for the final qualitative synthesis of the present systematic review. PKA = papilliferous keratoameloblastoma.

Figure 2

Line diagram illustrating the histopathological features of PKA. Ameloblast-like cells (1), stacks of keratin within cystic degeneration in the follicle (2), papillary projections into the follicle (3), acantholytic cells (4), keratin extruded into the stroma (5), necrotic material within the follicle (6), micropapillary structures in a follicle lined by squamous epithelial cells (7) and normal ameloblastoma-like follicle with central stellate reticulum-like cells (8). PKA = papilliferous keratoameloblastoma.