Ameloblastoma unicístico multiloculado em jovem: relato de caso

Abstract

Ameloblastomas are epithelial odontogenic tumors which may arise from the dental lamina cells remains from the growing dental enamel, epithelium of dental cysts, or from the basal epithelium of the oral mucosa. The World Health Organization (WHO, 2017) currently defines four types of ameloblastomas, thus being: conventional ameloblastoma, unicystic ameloblastoma, peripheral ameloblastoma and metastatic ameloblastoma. The unicystic type is 15% more frequent than all the other types of the disease, and it has marsupialization as a therapeutic alternative. This work dwelves on a case study of a twelve years-old male patient, leukoderma, born in Ituiutaba (MG), who was brought to the Maxillo-facial Surgery & Traumatology Emergency Room in Federal University of Uberlândia’s Dentistry Department. The patient was brought in with complaints of a slow growth protuberance on the right side of his face. Through the extraoral physical examination, a painless, rigid swelling was found on the right side of the patient’s face, thus consisting of noticeable facial asymmetry. Through the intraoral physical examination, tooth 47 was found missing, as well as a laceration in the vestibular fold around the bottom right molars, which is related to a subtle trismus. Medical imaging exams provided a multiocular radiolucent image of approximately four centimetres wide, going through teeth 46, 47 and 48, presenting severe injury to tooth 48, reaching the coronoid process and causing considerable cortical bulging. Alongside the examinations and imaging, the patient underwent yellow secrection positive curettage, followed by marsupialization and an incisive biopsy, which microscopically determined the patient had unicystic ameloblastoma with luminous variant. After six months of treatment and good bone formation, complete lesion enucleation through curettage and a peripheral ostectomy were performed. The collected biological matter was sent in for an anatomohistopatological exam, in which the patient was once again diagnosed with unicystic ameloblastoma, now with mural and luminous variations. After nineteen months of clinical and medical imaging testing and treatment, the patient is now alright, being occasionally checked on, and free of ameloblastomas ressurfacing.