Ameloblastoma: analysis of 207 cases in a Nigerian teaching hospital.

OBJECTIVE: The aim of the study was to review all the cases of ameloblastoma seen at the Oral and Maxillofacial Surgery Clinic of the Lagos University Teaching Hospital, Nigeria, between 1980 and 2003. METHODS AND MATERIALS: In this retrospective study, case files and biopsy reports of new cases of ameloblastoma covering a 24-year period were retrieved and analyzed for sex, age on presentation, histologic type, and site distribution. RESULTS: A total of 207 cases of ameloblastoma were seen in the given period. One hundred and ninety-eight (95.7%) were benign, and 9 (4.3%) were malignant. A male-to-female ratio of 1.1:1 was found. The average ages on presentation for ameloblastoma and ameloblastic carcinoma were 31.67 and 46.44 years, respectively. The lesion was found to be more common in the premolar-molar region of the mandible. The most common histologic type was follicular ameloblastoma (25.1%). Nine (4.3%) cases of ameloblastic carcinoma were also reported. CONCLUSIONS: Ameloblastoma with a predilection for the posterior mandibular region is relatively common in our environment. Sex and site distributions are similar to previous reports in the literature.     

Oral lichenoid dysplasia: a clinicopathologic analysis

Three women had a diagnosis of oral lichen planus (OLP), which was made on the basis of clinical and histologic features. All three had persistent burning pain associated with large mucosal lesions. Changes in the color (red, red and white, white), configuration, and severity of the lesions were unpredictable and did not correlate well with topical corticosteroid therapy. Only one patient used tobacco (cigarettes)--this patient had recurrent oral candidiasis and was receiving multiple medications. One of the two nonsmokers was a denture wearer with a single episode of candidiasis. After 63, 32, and 56 (mean 50) months, carcinoma developed in all three. In retrospect, the initial biopsy specimens of two patients exhibited lichenoid dysplasia, whereas that of the third showed only lichenoid mucositis. Although speckled erythroplakia was the earliest clinical sign of a classic, nonregressing premalignant lesion, it already signaled the presence of invasive carcinoma. Some early epithelial dysplasias appear to have a robust inflammatory/immunologic response to the antigenically (but as yet not histologically) altered dysplastic epithelium and a high probability of at least temporary resolution. Mucosal erythema of obscure origin displaying spontaneous, usually temporary, partial to complete regression may be common to both purely inflammatory conditions like lichen planus and early epithelial dysplasia. We contend that some, if not most, cases of apparent malignant transformation of OLP likely represent red and white lesions that were dysplastic from their inception but that mimic OLP both clinically and histologically.     

Ameloblastoma: a clinical, radiographic, and histopathologic analysis of 71 cases

OBJECTIVES: The purpose of this study was to compare the clinical, radiologic, and histopathologic features of 71 intraosseous ameloblastomas. STUDY DESIGN: Data with respect to the patients' ages, sex, tumor locations, and surgical treatment history, as well as the radiographic findings and number of recurrences, were analyzed. The histologic types of and radiologic findings regarding tumors with higher recurrence rates were also investigated. RESULTS: The patients' ages at biopsy ranged from 11 to 70 years (mean, 30.4 years). Thirty-nine (54.9%) of the 71 subjects were males, and 32 (45.1%) were females. Sixty-two (87.3%) of the 71 ameloblastomas were located in the mandible. Swelling was the most common symptom and was experienced by 27 (38.0%) patients. Radiographically, 42 (59.2%) of the 71 tumors were unilocular with a well-demarcated border. Of the remaining 29 cases, 14 were multilocular, 2 were of soap-bubble shape, and 13 were unknown in appearance. The most common histologic pattern was plexiform, rather than follicular or acanthomatous. Sixteen cases of ameloblastoma had developed in a cyst. The overall recurrence rate was 21.1%, and the average age of the patient at recurrence was 26.4 years. CONCLUSIONS: When the diagnosis of ameloblastoma in young people remains in doubt after clinical and radiologic examination, a biopsy is necessary. Long-term follow-up at regular intervals after surgery is also recommended.     

Ameloblastoma: a surgeon's dilemma.

PURPOSE: To investigate whether there were any significant differences in the mode of presentation, treatment, and outcome of patients presenting with a primary diagnosis of ameloblastoma in Glasgow, Scotland and San Francisco, CA. MATERIALS AND METHODS: All cases of ameloblastoma seen in both institutions between January 1, 1980 and December 31, 1999 were included in this study. Mode of presentation, radiographic appearance, histologic appearance, treatment, and follow-up were recorded. RESULTS: There were no significant differences in the clinical features on presentation (swelling, followed by pain, and altered sensation), the radiographic appearance (unilocular approximately 30% and multilocular 70%), or management with either local treatment (enucleation and/or curettage in just over 50% of cases) or radical treatment (a form of resection in under 50%) in the 50 cases included in this study. Primary care by conservative treatment led to a recurrence in approximately 80% of cases and this included cases of unicystic ameloblastoma. CONCLUSION: The mode of presentation, diagnosis, and management of the ameloblastoma was remarkably similar in Glasgow and San Francisco. The recurrence rate following local enucleation and curettage was unacceptably high, and this included the cases of unicystic ameloblastoma, which should be treated more aggressively than has been recommended in the past.     

Ameloblastoma of the mandible: a case report

This report describes the case of a 60-year-old male who presented with a radiolucent lesion between his mandibular right premolars. The original radiographic diagnosis was a lateral periodontal cyst, but surgery produced biopsy material that proved to be an ameloblastoma. A discussion on developing a differential diagnosis is presented.     

头颈部横纹肌肉瘤11例临床病理学分析

目的：探讨头颈部横纹肌肉瘤（rhabdomyosarcoma,RMS）的临床病理学特征、免疫表型及鉴别诊断。方法：回顾性分析11例头颈部 RMS 的临床资料、病理形态和免疫组织化学标记结果。结果：11例患者中男性8例,女性3例。年龄2～51岁,中位年龄25岁。主要表现为头颈部痛性或无痛性肿块,组织学分型：胚胎型8例,腺泡型3例。免疫组织化学结果显示瘤细胞均表达结蛋白、波形蛋白;肌调节蛋白（MyoD1）、生肌蛋白（myogenin）的阳性率分别为45％、55％;2例表达突触素,所有病例均不表达广谱角蛋白、白细胞共同抗原及 S-100。术后随访6个月～5年,其中2例死亡,4例复发,2例转移。结论：头颈部横纹肌肉瘤罕见,临床症状不典型,病理诊断需结合组织学形态及免疫表型。     

Ameloblastoma located in the alveolar bone: a case report

A small ameloblastoma located in the alveolar bone of a 34-year-old male is presented. Clinical examination revealed slight swelling of the alveolar bone between the lower second premolar and first molar areas with bone-like hardness, and radiographic examination showed a well circumscribed radiolucent lesion surrounded by a thin radiopaque layer, within which was contained the root of the second premolar tooth. Histopathologically, the lesion was compatible with a diagnosis of follicular ameloblastoma. A review of the literature yielded only four cases of small ameloblastoma located in the alveolar bone. These four previously reported cases and the present case strongly suggest that a small ameloblastoma located in the alveolar bone of adults arises from Malassez's epithelial rests scattered in the periodontal membrane.     

口腔静脉湖20例临床病理分析

目的：提高对口腔静脉湖（oral venous lakes,OVL)的认识并探讨其最佳治疗方法。方法：对20例OVL患者的临床表现，病理和手术治疗进行了详细观察。结果：20例中男性11例，女性9例，病变最大1．2cm，最大0．3cm;18例发生于下唇或下唇前庭沟处的粘膜下，另2例分别位于颊粘膜及上唇唇红处；病变触诊呈囊性，挤压体积不收缩，体位试验阴性，OVL病理表现为血管扩张充血，部分病例血管腔内血栓形成及机化，结论：OVL是小静脉局限性的病理性结构异常，其治疗均采用手术切除或摘除，20例术后随访8个月－4年无一例复发，手术治疗应作为OVL治疗的首先方法。     

Distribution of prosthetic appliances in young persons

In fixed prosthodontics, analysis of the distribution of basic prosthetic appliances according to sex, dental arch and particular types of teeth, is quite understandably needed. Therefore, these relations were analyzed in a sample of young adults. The aim was to find out the trends prevailing in our population, that may have proved useful in choosing appropriate measures in prosthetic therapy. Aimed clinical studies were conducted in 5665 students, 3078 females and 2587 males aged 18-20 years. The results obtained pointed to a significant difference in the prosthetic appliances between the upper and lower jaws (89.36% and 10.64%, respectively). Of the total of 1306 appliances in both jaws, 994 (76%) referred to anterior teeth, including first premolars, indicating the prevalence of esthetic requests and indications as compared to the functional ones. According to age, 57% of the total number of prosthetic appliances were made for females and 43% males.     

Ameloblastoma in children and adolescents

This study first reviewed the data of 37 patients aged 18 years and younger with ameloblastoma over a 16-year period and then reviewed the literature on this subject from 1970 to 2009. Of 37 patients with ameloblastoma, 23 were male and 14 were female, a ratio of 1.6:1. The mean age was 14.8 years. All lesions were in the mandible. Clinical typing included 28 solid type and 9 unicystic type. Ten cases were recurrent (27.0%). A series of literature review disclosed 233 well-documented cases of ameloblastoma in children and adolescents. The ages ranged from 4 to 20 years with a mean age of 14.5 years. The distribution among males and females were almost identical: 53.6% (125/233) males and 46.4% (108/233) females (1.16:1). The mandible was affected in 225 (96.6%), the maxilla in 8 (3.4%). Histologically, solid type (63.1%) predominated over unicystic type (36.9%). Of 226, 123 (54.4%) patients were treated with radical resection, 103 (45.6%) underwent conservative method. Owing to a high recurrent rate of ameloblastoma, solid type of tumors should be approached with radical surgical treatment, while conservative measure can be applied selectively to unicystic type. Long-term follow-up is important because recurrence may appear years after tumor removal.