Abstract
We encountered a case of ameloblastona that recurred 40 years after the first operation. We performed hemilateral resection of the mandible and extensive skin resection in combination, and instantly carried out reconstruction using a D-P (deltopectoral) skin flap for the buccal defect resulting from the resection. This paper is a report of our findings.
The patient was a 65-year old woman. Diagnosed as having tumor of the right mandible, she underwent resection 40 years ago. With a recurrence noted 15 years thereafter, she had radiotherapy. At the first visit, a tumor mass 6.5×5.8cm with an ulcer was noted in the skin of the rigth mandible. An ulcer 4.0×2.5cm also formed in the mouth.
X-ray examination revealed a goose egg-sized multicystic bone resorption at the angle of right mandible which was accompanied by pathological fracture. Upon histological examination, ameloblastoma was diagnosed but malignant pattern was observed.
The D-P skin flap was prepared before resection. The intermediate layer of the skin collected from the thigh was transplanted on the reverse side of the skin flap. A total of three operations, with the resection in between, were performed. The patient progressed favorably after each operation. Difficulty in opening the mouth, dysphagia or dysphasia were not observed.
The resected specimen was massive, weighing 114g. Histological findings of the specimen were similar to the results of biopsy. Basically it was of the plexiform type and there was no evidence of malignancy.
The transplanted skin flap in the reconstructed cheek survived both inside and outside the mouth. At present, 6 years and 6 months after the operation, no recurrence has been observed.
