Hitesh Bansal, M Samani, M McGurk
The ameloblastoma is a histologically benign, but locally invasive, tumour of odontogenic epithelium. They are the most common odontogenic tumour, accounting for about 1% of all oral tumours, and about 11% of odontogenic tumours. This purpose of this case report is to present a novel treatment for mandibular ameloblastoma.
A 23 year old British female sought dental evaluation due to a swelling of the jaw bilaterally. Her dentist referred her on to the head and neck oncology service at Guy’s Hospital, for possible ameloblastoma. Imaging and biopsy carried out showed that this lesion was compatible with an ameloblastoma. The patient was reluctant to proceed with surgery. Consent was then obtained from the patient to perform a less invasive technique to avoid resection and tooth extractions. The patient was treated under sedation in a day case setting. The tumour contents were aspirated; the lined cavity filled with Carnoy’s solution; and left for twenty minutes. This was aspirated and the application repeated a second time. Follow up imaging showed resolution of the ameloblastoma, with new bone formation. The swelling had gone down noticeably, and the patient was very satisfied with the results. Discussion Surgery is the mainstay of treatment for ameloblastomas; comprising of two options; ‘conservative’ vs ‘radical’. The more radical approach is the norm but is associated with serious complications.
This case is unique in that both enucleation and jaw resection were avoided, and the contents of the ameloblastoma were simply aspirated followed by the application of carnoy’s solution. General anaesthesia and inpatient stay were not necessary; furthermore the young patient was able to retain her teeth and experienced no disfigurement post operatively which undoubtedly maintained a good quality of life compared with other surgical treatment options.