Abstract
Introduction: According to the World Health Organization, ameloblastoma is a benign intraosseous epithelial odontogenic tumor that grows slowly but progressively, potentially reaching significant size and causing considerable morbidity. It has a high recurrence rate if not completely removed. Its management is challenging due to its impact on patients’ quality of life. The purpose of this study is to present our institutional experience at the Radiotherapy Department of Salah Azaiez Institute in Tunisia through two cases of mandibular ameloblastoma.
Case presentation: The first case involves a 46-year-old man with nonotable medica lhistory, who consulted his dentist for a painless gingival swelling. A macrobiopsy revealed an ameloblastoma, leading to radical surgery. He underwent a hemimaxillectomy with removal of half of the palatal vault. Recovery was uneventful. Histopathological examination confirmed a follicular-type ameloblastoma. A follow-up CT scan three months later showed osteolytic lesions involving the right pterygoid and zygomatic processes, indicating residual tumor extension measuring 12 x 9 x 8 mm.Amultidisciplinary team decided on adjuvant radiotherapy using IMRT at a dose of 60 Gy.
The second case concerns a 72-year-old woman who had surgery for a right mandibular ameloblastoma in 1987 without adjuvant radiotherapy. In 2006, imaging revealed a recurrence at the same site. Following additional surgery, progression wasnoted,and 3D-conformalradiotherapyat50 Gywasadministered.Unfortunately,the tumorcontinued to progress aggressively, and the patient received palliative care.
Conclusion: Ameloblastoma is a benign odontogenic tumor with aggressive behavior and a high risk of recurrence. While surgery remainsthe mainstay oftreatment, radiotherapy hasa keyrole in managing locally advanced, recurrent, inoperable, or metastatic disease
Key Words: Ameloblastoma, Surgery, Radiotherapy, Combined treatment.
