Multicystic Intraosseous Ameloblastoma With Follicular Pattern in a 16-Year-Old Male: A Case Report

TL;DR

A 16-year-old male was diagnosed with a rare type of ameloblastoma tumor in the jaw, highlighting the need for careful treatment planning in adolescents.

Contribution

This case report documents the rare occurrence of conventional ameloblastoma with follicular pattern in an adolescent.

Findings

The tumor exhibited a multicystic intraosseous follicular pattern confirmed via histopathology.

Reverse polarity of basal cells and wall invasion by ameloblastic epithelium were observed.

Radical resection with reconstruction is recommended to prevent recurrence in such cases.

Abstract

Ameloblastoma is a benign, slow-growing, locally aggressive tumor derived from dental lamina and odontogenic epithelium. Though mainly occurring in adults, its presence has also been reported in the pediatric population. From the three subtypes of this neoplasm, the conventional (solid/multicystic) variant shows high rates of recurrence, possibly associated with the gain-of-function mutation in the BRAF V600E MAPK pathway.

A 16-year-old African American male presented with swelling, cortical expansion of the right mandible extending from the midline to the third molar region. Cone-beam computed tomography revealed an extensive multilocular radiolucency with a soap bubble or honeycombed appearance. Histopathological examination after incisional biopsy confirmed a multicystic intraosseous follicular pattern ameloblastoma. Presence of reverse polarity of basal cells and cystic structures lined by ameloblastic epithelium with wall invasion were observed.

This case highlights the presentation of conventional ameloblastoma in an adolescent. Conventional (solid/multicystic) ameloblastoma in this patient group requires careful consideration of treatment plan. Radical resection with adequate margins, often combined with immediate reconstruction like fibular free flap, offers the best chance for preventing potential for recurrence.

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