Ameloblastoma with Nodal Metastasis in an Adolescent: A Multifaceted Diagnostic and Surgical Endeavor

Introduction

Ameloblastoma, a benign intraosseous epithelial odontogenic tumor, presents a unique clinical challenge characterized by progressive growth and a predilection for local recurrence if inadequately managed. This enigmatic entity exhibits variable geographic prevalence, with a global incidence of approximately 0.92 cases per million person-years [1]. Although often indolent during its early stages, ameloblastoma attains clinical significance as it reaches considerable dimensions, leading to tissue expansion and perforation, thereby causing significant facial deformities.

The genesis of ameloblastoma is influenced by an array of risk factors, encompassing chronic inflammation, chemical exposures, human papillomavirus infections, nutritional deficiencies, suboptimal oral hygiene, and distinctive genetic polymorphisms [2]. 

In terms of classification, contemporary taxonomy simplifies the spectrum to three main categories: ameloblastoma, unicystic ameloblastoma, and extraosseous/peripheral types. The majority of cases present within the 30-60 years age group, with a slight male predominance, and the mandible emerges as the predominant anatomical site [3].

Metastasizing ameloblatoma, although a rare phenomenon, shares histological similarities with its benign solid/multicystic counterpart at the primary site. Intriguingly, areas of benign histology may also manifest at anatomically distant locations, a phenomenon recognized as metastases [4]. 

Among these secondary sites, follicular ameloblastoma exhibits the highest incidence, followed by the plexiform subtype. The lungs stand as the most commonly affected secondary site [5].