Adrián MDS, Delgado MSD, Gudiño MRA, García ME, García GHA, Villarroel DM

Language: Spanish
References: 10
Page: 87-93
PDF size: 306.23 Kb.

ABSTRACT

Introduction: ameloblastoma is the second most common ontogenetic tumor. They are locally invasive, slow-growing tumors that follow a benign course with a tendency to expansion and destruction of the maxillary bones, infiltration into surrounding tissues, and high rates of local recurrence. The tumor is usually asymptomatic, and smaller lesions are detected only during radiographic examination. Most studies emphasize that improper treatment of ameloblastoma will result in recurrence. The recommended treatment for recurrences is radical surgery. Presentation of case: a 56-year-old male patient case is presented, who attended the consultation of the maxillofacial surgery service of the University Hospital of Caracas, in 2020. The patient has a surgical history of 3 right mandibular ameloblastoma exeresis surgeries. On clinical examination, facial asymmetry associated with increased volume in the right temporal region is observed. A computerized tomography (CT) of the head was evaluated, an isodense image in the right temporal fossa region, which was observed infiltrating the right temporal muscle, extending to the right TMJ region. Results: the patient was prepared to perform an excisional biopsy of the lesion. A coronal approach was performed with extension to the preauricular region. Dissection by planes until exposing the tumor lesion, which was located throughout the entire extent of the right temporal fossa, infiltrating 2/3 of the right temporal muscle. Various surgical treatment modalities have been described from "conservative" to "radical". However, conservative treatment modalities have very high recurrence rates. Recurrence is attributed to inadequate removal, aggressive histology, and dissemination along the muscle insertion. Conclusions: the radical surgical approach, taking adequate safety margins, is the most suitable management to avoid recurrences. At the same time, it is important to carry out regular follow-up with these patients.

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