Unicystisk ameloblastom – fem års klinisk og radiologisk opfølgning
Baggrund – Det unicystiske ameloblastom er en benign odontogen tumor, der histopatologisk præsenterer sig som en cystisk forandring. Den diagnosticeres hyppigst hos yngre mennesker og forekommer fortrinsvis i underkæben. Årsagen er ukendt. Det unicystiske ameloblastom er oftest asymptomatisk og diagnosticeres som regel i forbindelse med rutinemæssig røntgenundersøgelse. Recidivtendensen er generelt lavere end ved konventionelt ameloblastom, men i nogle tilfælde er recidivtendensen dog høj. Patienttilfælde – En 20-årig mand blev henvist fra egen tandlæge til Kæbekirurgisk Afdeling, Aalborg Universitetshospital, mhp. diagnostik og behandling af hævelse svarende til venstre ansigtshalvdel. Røntgenoptagelse viste en velafgrænset multilokulær radiolucens i venstre side af underkæben med involvering af en retineret visdomstand. Der blev foretaget enukleation, og ved etårs kontrol viste panoramarøntgen recidiv. Der blev foretaget fornyet kirurgisk fjernelse, og ved femårs kontrol fandtes klinisk og radiologisk knogleheling uden tegn på recidiv. Konklusion – Det unicystiske ameloblastom er en sjældent forekommende tumor, som klinisk og radiologisk kan være vanskelig at adskille fra en follikulær cyste eller keratocyste, hvorfor histologisk undersøgelse er obligatorisk på grund af recidivtendensen. Tumoren behandles med kirurgisk fjernelse. Imidlertid er recidivfrekvensen høj, hvorfor et langvarigt klinisk og radiologisk kontrolforløb er nødvendigt.
Unicystic ameloblastoma – 5-year clinical and radiographic follow-up: Background – Unicystic ameloblastoma is a benign odontogenic tumour that histopathologically presents itself as a cystic lesion. They are mostly seen in younger patients and are mainly found in the lower jaw. The cause is unknown. Unicystic ameloblastoma is usually asymptomatic and is often diagnosed by routine radiographic examination. The recurrence rate is generally lower compared to the conventional ameloblastoma, although in some cases the recurrence rate is high. Case study – A 20 year-old male was referred from his own dentist to the Department of Oral and Maxillofacial Surgery, Aalborg University Hospital for diagnosis and treatment of a swelling in the left side of the face. Panoramic x-ray showed a well-defined multilocular radiolucency in the left mandible with involvement of an unerupted mandibular third molar. The lesion was removed by enucleation but a recurrence was detected on the panoramic x-ray at the 1-year follow-up. This was surgical removed and the 5-year follow-up showed no sign of recurrence. Conclusion – Unicystic ameloblastoma is a rare benign tumour which clinically and radiographically can be difficult to separate from a dentigerous cyst or odontogenic keratocys. Histological examination is required because of the recurrence rate. The tumour is treated by surgical removal. However, the recurrence rate is high and a prolonged clinical and radiographic follow-up is necessary.
