title: Intracranial Ameloblastoma Arising from the Maxilla: An Interdisciplinary Surgical Approach.
abstract: BackgroundAmeloblastomas are a rare tumor entity accounting for only 10% of all odontogenic tumors. They mostly originate from the mandible. Only a few cases are known to grow aggressively and to invade the orbit, nasal cavity, or even the brain.Patient and Methods/Case ReportWe present the case of a 57-year-old patient who was admitted with a huge tumor involving the nasal cavity, the left maxilla, and the anterior fossa. Histologic diagnosis was made by biopsy. A combined two-stage neurosurgical maxillofacial approach was planned. First the intracranial tumor mass was removed using bifrontal trepanation. A duraplasty was sewn in to cover the brain. In the second procedure, a combined bifrontal and midfacial approach was used by craniofacial plastic surgeons and neurosurgeons. A perisinusoidal tumor mass and retropharyngeal tumor mass was removed up to the skull base. The left orbit was completely exenterated, and a fibular bone-muscle graft was used for palatal, orbital, and facial reconstruction. The facial vein and artery were carefully prepared to feed the bone-muscle graft by end-to-end anastomoses.ConclusionAmeloblastomas are very rare slow-growing tumors that show a tendency to recur. They are responsible for only 1% of all oral tumors. Their growth can be enormous, and they can extend into sinusoidal cavities, the orbit, and the brain. Complex and extensive palliative surgery can ease the concerns of these patients and prolong their survival.
authors.affiliation: Department of Neurosurgery, Goethe-University Frankfurt, Frankfurt, Germany.
authors.forename: Johanna
authors.initials: J
authors.lastname: Quick-Weller
authors.affiliation: Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe-University Frankfurt, Frankfurt, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Koch
authors.affiliation: Department of Neurosurgery, Goethe-University Frankfurt, Frankfurt, Germany.
authors.forename: Nazife
authors.initials: N
authors.lastname: Dinc
authors.affiliation: Institute for Neuroradiology, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lescher
authors.affiliation: Department of Neurosurgery, Goethe-University Frankfurt, Frankfurt, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Baumgarten
authors.affiliation: Edinger Institute, Neurological Institute, Goethe-University Frankfurt, Frankfurt, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Harter
authors.affiliation: Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe-University Frankfurt, Frankfurt, Germany.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Scheerer
authors.affiliation: Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe-University Frankfurt, Frankfurt, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Sader
authors.affiliation: Department of Neurosurgery, Goethe-University Frankfurt, Frankfurt, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Seifert
authors.affiliation: Department of Neurosurgery, Goethe-University Frankfurt, Frankfurt, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Marquardt
authors.affiliation: Department of Neurosurgery, Goethe-University Frankfurt, Frankfurt, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Freiman
mesh_terms: D000564:Ameloblastoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007573:Jaw Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D009915:Orbit / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods