Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지

EFFECT ON THE ENUCLEATION OF THE INTRAOSSEOUS AMELOBLASTOMA

골내 법랑아세포종의 적출술 후 치료효과

  • Kim, Hee-Kyeong (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Lee, Eui-Wung (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University)
  • 김희경 (연세대학교 치과대학 구강악안면외과학 교실) ;
  • 이의웅 (연세대학교 치과대학 구강악안면외과학 교실)
  • Published : 2003.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Ameloblastoma is cytologically a benign tumor, but is clinically characterized by infiltrative growth and high recurrency. The criteria for surgical treatment of ameloblastoma has not yet established and it is generally accepted that ameloblastoma be treated differently based on clinical types. The purpose of this paper is to consider effectiveness of enucleation in large-sized intraosseous ameloblastoma that has treated more frequently by radical treatment. 39 cases of the intraosseous ameloblastomas were treated by enucleation in the department of oral and maxillofacial surgery of Yonsei University, dental college from February 1990 to January 2001. 25 cases were selected because they were large in size that could produce facial disfigurement or pathologic fracture of jaws. They were radiographically characterized by the cortical bone that was expanded or eroded locally and histopathologically by 19 solid ameloblastomas and 6 intramural type of unicystic ameloblastomas. Among the 25 cases, 4 cases - 3 solid ameloblastomas and 1 intramural type of ameloblastoma - recurred. Recurrence rate was 16%. The compact bone which is not invaded by ameloblastoma was used as surgical margin of enucleation with accompanying chemical cauterization for killing the residual tumor cells. This may have been the reason for the low recurrence rate. So, it is considered that enucleation and long-term follow-up enable the large-sized intraosseous ameloblastomas that were characterized by almost destroyed cancellous bone and expanded or discontinued cortical bone to treat minimizing facial disfigurement and masticatory dysfunction and sociopsychological impact produced by radical treatment. I recommend that the large-sized intraosseous ameloblastomas without involvement to the surrounding soft tissues be first treated by enucleation.

Keywords

References

  1. 김명진, 김여갑외 16인: 구강암. 서울: 지성출판사. 2002;242-256.
  2. 정세용, 이의웅: 법랑아세포종의 병리학적 및 조직화학적 연구. 대한구강악안면외과학회지 1987;13(1):161-170.
  3. Gardner DG: A pathologist's approach to the treatment of ameloblastoma. J Oral Maxillofac Surg 1984;42:161-166. https://doi.org/10.1016/S0278-2391(84)80026-9
  4. Mehlisch DR, Dahlin DC, Masson JK: Ameloblastoma: a clinicopathologic report. J Oral Surg 1972;30:9-22.
  5. Sehdev MK, Huvos AG, Strong EW, Gerold FP, Willis GW: Ameloblastoma of maxilla And mandible. Cancer 1974;33:324-333. https://doi.org/10.1002/1097-0142(197402)33:2<324::AID-CNCR2820330205>3.0.CO;2-U
  6. Shatkin S, Hoffmeister FS: Ameloblastoma: A rational approach to therapy. Oral Surg Oral Med Oral Pathol 1965;20(4):421-435. https://doi.org/10.1016/0030-4220(65)90231-8
  7. Pandya NJ, Stuteville OH: Treatment of ameloblastoma. J Plast Reconstr Surg 1972;50(3):242-248. https://doi.org/10.1097/00006534-197209000-00008
  8. Crawley WA, Levin LS: Treatment of the ameloblastoma. A controversy. Cancer 1978;42:357-363. https://doi.org/10.1002/1097-0142(197807)42:1<357::AID-CNCR2820420154>3.0.CO;2-H
  9. Hinds EC, Pleasants JE, Snyder PL: Management of ameloblastomas. J Oral Surg 1964;7:1169 -1177. https://doi.org/10.1016/0030-4220(54)90309-6
  10. Huffman GG, Thatcher JW: Ameloblastoma-the conservative surgical approach to treatment: report of four cases. J Oral Surg 1974;32:850-854. https://doi.org/10.1016/0030-4220(71)90313-6
  11. Nakamura N, Higuchi Y, Mitsuyasu T, Sandra F, Ohishi M: Comparison of long-term results between different approaches to ameloblastoma. Oral Surg Oral Med Oral Pathol 2002;93:13-20. https://doi.org/10.1067/moe.2002.119517
  12. Robinson L, Martinez MG: Unicystic ameloblastoma: A prognostically distinct entity. Cancer 1977;40:2278-2285. https://doi.org/10.1002/1097-0142(197711)40:5<2278::AID-CNCR2820400539>3.0.CO;2-L
  13. Kramer IRH: Ameloblastoma: A clinical-pathological appraisal. Br J Oral Surg 1963;1:13-28. https://doi.org/10.1016/S0007-117X(63)80044-X
  14. Pandya NJ, Stuteville OH: Treatment of ameloblastoma. J Plast Reconstr Surg 1972;50(3):242-248. https://doi.org/10.1097/00006534-197209000-00008
  15. Small IA, Waldron CA: Ameloblastomas of the jaws. J Oral Surg 1955;8:281-297. https://doi.org/10.1016/0030-4220(55)90350-9
  16. Cohen MA, Hertzanu Y, Mendelsohn DB: Computed tomography in the diagnosis and treatment of mandibular ameloblastoma: Report of cases. J Oral Maxillofac Surg 1985;43:796-801. https://doi.org/10.1016/0278-2391(85)90338-6
  17. Williams TP: Management of ameloblastoma: A changing perspective. J Oral Maxillofac Surg 1993;51:1064-1070. https://doi.org/10.1016/S0278-2391(10)80440-9
  18. Ackerman GL, Aitini M, Shear M: The unicystic ameloblastoma: A clinicopathologic study of 57 cases. J Oral Pathol 1988;17:541-546. https://doi.org/10.1111/j.1600-0714.1988.tb01331.x
  19. Shteyer A, Lustmann J, Lewin-Epstein J: The mural ameloblastoma: A review of literature. J Oral Surg 1978;36:866-869.
  20. Gardner DG, Corio RL: Plexiform unicystic ameloblastoma. A variant of ameloblastoma with a low-recurrence rate after enucleation. Cancer 1984;53:1730-1735. https://doi.org/10.1002/1097-0142(19840415)53:8<1730::AID-CNCR2820530819>3.0.CO;2-U
  21. Eversole LR, Leider AS, Strub D: Radiographic characteristics of cystogenic ameloblastoma. Oral Surg Oral Med Oral Pathol 1984;57:572-577. https://doi.org/10.1016/0030-4220(84)90320-7
  22. Olaitan AA, Adekeye EO: Unicystic ameloblastoma of the mandible: A long-term follow-up. J Oral Maxillofac Surg 1997;55:345-348. https://doi.org/10.1016/S0278-2391(97)90122-1
  23. Waldron CA: Ameloblastoma in perspective. J Oral Surg 1966;24:331-333.
  24. Olaitan AA, Adeola DS, Adekeye EO: Ameloblastoma: Clinical features and management of 315 cases from Kaduna, Nigeria. J Craniomaxillofac Surg 1993;21:351-360. https://doi.org/10.1016/S1010-5182(05)80497-4
  25. Hinds EC, Pleasants JE, Snyder PL: Management of ameloblastomas. J Oral Surg 1964;7:1169-1177. https://doi.org/10.1016/0030-4220(54)90309-6
  26. Shafer WG, Hine MK, Levy BM: A textbook of oral pathology. 4th ed. Philadelphia, WB Saunders. 1983;276-285.
  27. Mu¨ller H, Slootweg PJ: The growth characteristics of multilocular ameloblastomas. A histological investigation with some inferences with regard to operative procedures. J Oral Maxillofac Surg 1985; 13:224-230.
  28. Feinberg SE, Steinberg B: Surgical management of ameloblastoma. Current status of the literature. Oral Surg Oral Med Oral Pathol 1996;81(4):383-388. https://doi.org/10.1016/S1079-2104(96)80012-6
  29. Muller H, Slootweg PJ: The ameloblastoma, the controversial approach to therapy. J Maxillofac Surg 1985;13:79-84. https://doi.org/10.1016/S0301-0503(85)80021-7
  30. Ueno S, Mushimoto K, Shirasu R: Prognostic evaluation of ameloblastoma based on histologic and radiographic typing. J Oral Maxillofac Surg 1989;47:11-15.
  31. Kim SG, Jang HS: Ameloblastoma: A clinical, radiographic, and histopathologic analysis of 71 cases. Oral Surg Oral Med Oral Pathol 2001;91:649-653. https://doi.org/10.1067/moe.2001.114160
  32. Small IA: recurrent ameloblastoma, twenty-five years after hemimandibulectomy. Oral Surg 1956;9:699-702. https://doi.org/10.1016/0030-4220(56)90245-6
  33. Hayward JR: Recurrent ameloblastoma 30 years after surgical treatment. J Oral Surg 1973;31:368-372.