Abstract

Relevance: Ameloblastoma is a rare benign epithelial tumour, considered the most aggressive among benign odontogenic tumours, with a recurrence risk of up to 50% within the first 5 years after treatment. Tumours of the upper jaw are more complex due to their proximity to vital anatomical structures, requiring special attention in diagnosis and treatment.

Objective: To draw attention to maxillary ameloblastoma as a rare, aggressive, benign tumour through a clinical case example, highlighting treatment methods and recurrence prevention strategies.

Materials and Methods: A patient with complaints of unilateral nasal congestion, difficulty in nasal breathing, and headaches for 6 months was examined at the Department of Inflammatory Diseases of the State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Sciences of Ukraine”. Radiological imaging was performed, specifically computed tomography with intravenous contrast enhancement using Tomohexol.

Results and Discussion: CT revealed a soft tissue mass with irregular, indistinct contours on the right side, extending from the upper-medial parts of the maxillary sinus into the nasal cavity. Remodelling of the posterior-lateral wall of the right maxillary sinus was observed.

A decision was made to perform endoscopic endonasal tumor removal. During surgery, endoscopic partial septoplasty, right-sided endonasal partial antrostomy type II (TEMP-II), ethmoidotomy, and frontotomy were performed.

Extraosseous/peripheral ameloblastoma is the rarest variant of ameloblastoma, predominantly affecting individuals aged 40 to 60, with a slight male predominance – fully consistent with our clinical case. Typically, this tumor does not involve bone destruction, although superficial bone erosion may occur, which distinguishes our patient’s case from descriptions in the literature. The treatment of choice is complete tumour resection with 1-2 cm margins within healthy tissue. There is no evidence supporting chemotherapy or radiation therapy.

Conclusions. Ameloblastoma remains poorly understood and, despite its rarity, can affect the maxillary sinuses. Radical resection and regular follow-up are key to successful treatment, as this tumour, despite its benign nature, carries a high risk of recurrence.

Keywords: Ameloblastoma, maxilla, neoplasm, odontogenic tumour.