Ameloblastoma: a surgeon's dilemma.
OBJECTIVE
To investigate whether there were any significant differences in the mode of presentation, treatment, and outcome of patients presenting with a primary diagnosis of ameloblastoma in Glasgow, Scotland and San Francisco, CA.


METHODS
All cases of ameloblastoma seen in both institutions between January 1, 1980 and December 31, 1999 were included in this study. Mode of presentation, radiographic appearance, histologic appearance, treatment, and follow-up were recorded.


RESULTS
There were no significant differences in the clinical features on presentation (swelling, followed by pain, and altered sensation), the radiographic appearance (unilocular approximately 30% and multilocular 70%), or management with either local treatment (enucleation and/or curettage in just over 50% of cases) or radical treatment (a form of resection in under 50%) in the 50 cases included in this study. Primary care by conservative treatment led to a recurrence in approximately 80% of cases and this included cases of unicystic ameloblastoma.


CONCLUSIONS
The mode of presentation, diagnosis, and management of the ameloblastoma was remarkably similar in Glasgow and San Francisco. The recurrence rate following local enucleation and curettage was unacceptably high, and this included the cases of unicystic ameloblastoma, which should be treated more aggressively than has been recommended in the past.
Ghandhi
Dinaz
D
Jinnah Medical and Dental College, Karachi, Pakistan.
Ayoub
Ashraf F
AF
Pogrel
M Anthony
MA
MacDonald
Gordon
G
Brocklebank
Laetitia M
LM
Moos
Khursheed F
KF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000564:Ameloblastoma / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008339:Mandibular Neoplasms / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D008441:Maxillary Neoplasms / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology