2017 Volume 60 Issue 4 Pages 181-188
Ameloblastoma is the most commonly occurring benign odontogenic tumor. It frequently occurs in the mandible, but is rather rare in the maxilla. Herein, we report a case of cystic ameloblastoma of the maxillary sinus.
The patient was a 61-year-old man who presented with the chief complaint of swelling of the face, over the right malar region. Clinical examination, including imaging examinations, performed at a neighborhood clinic revealed a huge cystic lesion in the right maxillary sinus, with thinning of the maxillary bone. He was then referred to our hospital. We performed endoscopic endonasal sinus surgery (ESS) for diagnosis and treatment. We removed the major part of the cystic lesion without the bottom part, but failed to successfully resect the base of the tumor. Because if we removed this part, the right maxillary sinus went through with the oral cavity, as its removal would have created a communication between the right maxillary sinus and the nasal cavity. Histopathological examination of the resected specimen revealed the diagnosis of ameloblastoma. At a later date, we performed right partial maxillectomy as additional treatment. The postoperative course was uneventful and there has been no evidence of recurrence until date.
Ameloblastoma is, in general, a benign locally invasive tumor, but it can metastasize to other organs or show malignant transformation. In addition, it shows a high likelihood of recurrence after surgery. Ameloblastoma frequently arises from the mandible, but is rare in the maxilla.
Patients with maxillary ameloblastoma are likely to initially visit the Department of Otolaryngology with symptoms such as swelling of the malar region. Therefore, otorhinolaryngologists must bear in mind the possibility of this condition when examining patients presenting to them with the aforementioned symptoms.
