Surgical treatment and reconstruction of recurrent ameloblastoma of the mandible complicated by orostomy: A clinical case

Abstract

Relevance: Ameloblastoma is one of the most common benign jaw tumors, characterized by locally invasive growth and a high recurrence rate. Despite its benign nature, the disease presents a significant clinical challenge due to bone destruction, the risk of functional impairment, and the need for complex maxillofacial reconstruction. Diagnostic and treatment methods such as MRI, CT, biopsy, and surgical resection remain essential. However, frequent relapses necessitate new therapeutic strategies and improved reconstructive approaches.

The study aimed to analyze a clinical case of recurrent ameloblastoma of the mandible complicated by orostomy, with an evaluation of the effectiveness of surgical treatment and reconstruction.

Methods: A rare clinical case involving a 63-year-old woman diagnosed and treated for mandibular ameloblastoma is described.

Results: The tumor was first diagnosed in 1997, with subsequent surgeries in 2002, 2009, 2016, and 2020 due to recurrences. In 2022, a combined surgery was performed, including tumor resection and soft tissue reconstruction using a skin-muscle flap. Histology confirmed the follicular type of ameloblastoma with epithelial nests, palisading cell arrangement, and stellate structures resembling the enamel organ. MRI in May 2025 showed no signs of recurrence. The patient has remained in stable remission for three years.

The disease has been tracked over nearly 30 years. The case confirms the effectiveness of a comprehensive surgical approach.

Conclusion: Despite its benign character, ameloblastoma requires active surgical management and long-term follow-up. This case underscores the importance of individualized treatment planning and interdisciplinary cooperation to improve outcomes and patient quality of life.