AB248. SOH25_AB_291. Case report: marsupialization of a unicystic ameloblastoma

Background: Ameloblastomas are benign odontogenic tumours of epithelial origin, occurring in both the maxilla and mandible. Although benign and slow-growing, they are locally invasive with malignant potential. Ameloblastomas account for approximately 10% of odontogenic tumours. Traditionally, treatment of choice was complete resection with at least a 1 centimetre margin due to the high recurrence rates and invasive nature of the disease. However, in more recent times in an effort to reduce the impact on patients’ quality of life, less invasive techniques, both surgical and non-surgical, are often favoured. In this instance, a thirty four-year-old man presented with swelling in the mandible causing discomfort and pain.

Methods: On imagining, a large unilocular radiolucency extending from the parasymphysis to the mandibular body bilaterally was noted. Complete surgical resection would have resulted in a segmental mandibulectomy. Although a higher recurrence risk, marsupialisation of the ameloblastoma was the treatment of choice in this case due to the proximity of the lesion to vital structures such as the inferior alveolar and mental nerves, as well as the invasive nature of a segmental mandibulectomy given the patient’s age and otherwise, good health. Following on from histopathological confirmation on initial marsupialisation, the procedure was repeatedly performed.

Results: The patient was kept under close observation and yearly radiographs showed bony regeneration and reduction in size of the lesion.

Conclusions: Disruption to the patient’s surrounding structures reduced significantly allowing the patient to keep his dentition intact as well as avoid surgical intervention.

Keywords: Ameloblastoma; cyst; marsupialization; odontogenic tumour; unicystic