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Atypical periosteal reaction and unusual bone involvement of ameloblastoma: A case report with 8-year follow-up

Imaging Science in Dentistry 2021³â 51±Ç 2È£ p.195 ~ 201
Charoenlarp Pornkawee, Silkosessak-Chaiudom Onanong, Vipismakul Vichittra,
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 ( Charoenlarp Pornkawee ) - Chulalongkorn University Faculty of Dentistry Department of Radiology
 ( Silkosessak-Chaiudom Onanong ) - Chulalongkorn University Faculty of Dentistry Department of Radiology
 ( Vipismakul Vichittra ) - Chulalongkorn University Faculty of Dentistry Department of Oral Pathology

Abstract


Unusual radiographic findings of intraosseous ameloblastoma have been reported and discussed. In the case discussed herein, cone-beam computed tomography (CBCT) clearly showed many radiographic features that were ambiguous on conventional radiographs, including an ill-defined periphery, extensive superficial buccal extension with minimal lingual extension, obvious bucco-crestal expansion, and multiple triangular (Codman¡¯s triangle-like) areas of periosteal reaction. Based on the above-mentioned findings, the differential diagnosis was a long-term infected benign or low-grade malignant lesion. An incisional biopsy was performed, and the histopathologic diagnosis was acanthomatous ameloblastoma. Recurrence of the lesion was clearly detected on CBCT images at 4 and 8 years after surgery. These unusual radiographic findings have never been reported to be associated with ameloblastoma, and thus may contribute to novel concepts in radiographic interpretation in the future. This report also underscores the important role played by CBCT as a comprehensive diagnostic tool and for definite confirmation of recurrence.

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Ameloblastoma; Cone-Beam Computed Tomography; Neoplasms; Periosteum

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