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Clinicopathological Profile of 80 Cases of Unicystic Ameloblastoma Aided by a Histopathological Comparison Using Modified Philipsen–Reichart Classification and Marx–Stern Classification

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Abstract

Unicystic ameloblastoma (UA) is an uncommon variant of ameloblastoma and behaves totally different from the solid multicystic variant of ameloblastoma (SMA); furthermore the histological subgroups of UA also show varied behavior regarding proliferation. The present multi-centric study was designed to present the clinicopathological features of unicystic ameloblastoma (UA) and to compare the two popular histological classifications systems. 80 satisfactory cases of UA were retrieved and evaluated for clinicopathological parameters from four teaching dental schools of North India. The cases were classified using modified Reichart and Philipsen system and Marx and Stern system followed by comparison of inter-observer variability. The results were analyzed using SPSS software. The mean age of occurrence was 30.79 ± 16.49 years. Males outnumbered females (M:F::1.67:1). The majority of cases occurred in the third decade irrespective of the gender. Most cases were found in body–angle–ramus region of the mandible. The modified Reichart and Philipsen classification yielded better interobserver agreement (kappa value 0.845). The modified Reichart and Philipsen classification yields better inter-rater agreement and is easy to reproduce amongst oral pathologists. Being simpler it may easily be understood by the operating surgeon for better treatment outcome.

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References

  1. Pandiar D, Shameena PM, Sudha S, Varma S, Manjusha P, Banyal VS, et al. Odontogenic tumors: a 13-year retrospective study of 395 cases in a South Indian Teaching Institute of Kerala. Oral Maxillofac Pathol J. 2015;6:602–8.

    Google Scholar 

  2. Reichart PA, Philipsen HP, Sonner S. Ameloblastoma: biological profile of 3677 cases. Eur J Cancer B. 1995;31B:86–99.

    Article  CAS  Google Scholar 

  3. Agbaje JO, Olumuyiwa Adisa A, Ivanova Petrova M, Adenike Olusanya A, Osayomi T, Ajibola Effiom O, et al. Biological profile of ameloblastoma and its location in the jaw in 1246 Nigerians. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;126:424–31.

    Article  Google Scholar 

  4. El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ, editors. Odontogenic and maxillofacial tumors. In: WHO classification of tumours of the head and neck, 4th ed. Lyon: IARC Press; 2017. pp. 203–60.

  5. Chaudhary Z, Sangwan V, Pal US, Sharma P. Unicystic ameloblastoma: a diagnostic dilemma. Natl J Maxillofac Surg. 2011;2:89–92.

    Article  Google Scholar 

  6. Ackermann GL, Altini M, Shear M. The unicystic ameloblastoma: a clinicopathological study of 57 cases. J Oral Pathol. 1988;17:541–6.

    Article  CAS  Google Scholar 

  7. Philipsen HP, Reichart PA. Unicystic ameloblastoma. a review of 193 cases from the literature. Oral Oncol. 1998;34:317–25.

    Article  CAS  Google Scholar 

  8. Mark RE, Stern D, editors. Odontogenic tumors. In: Oral and maxillofacial pathology: a rationale for diagnosis and treatment.  2nd ed. Hanover Park: Quintessence Publishing Co, Inc.; 2012. pp 667–84.

  9. McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22:276–82.

    Article  Google Scholar 

  10. Kessler HP. Intraosseous ameloblastoma. Oral Maxillofac Surg Clin N Am. 2004;16:309–22.

    Article  Google Scholar 

  11. Li TJ, Wu YT, Yu SF, Yu GY. Unicystic ameloblastoma: a clinicopathologic study of 33 Chinese patients. Am J Surg Pathol. 2000;24:1385–92.

    Article  CAS  Google Scholar 

  12. Rosenstein T, Pogrel MA, Smith RA, Regezi JA. Cystic ameloblastoma—behavior and treatment of 21 cases. J Oral Maxillofac Surg. 2001;59:1311–6.

    Article  CAS  Google Scholar 

  13. Lau SL, Samman N. Recurrence related to treatment modalities of unicystic ameloblastoma: a systematic review. Int J Oral Maxillofac Surg. 2006;35:681–90.

    Article  CAS  Google Scholar 

  14. Seintou A, Martinelli-Kläy CP, Lombardi T. Unicystic ameloblastoma in children: systematic review of clinicopathological features and treatment outcomes. Int J Oral Maxillofac Surg. 2014;43:405–12.

    Article  CAS  Google Scholar 

  15. Dodge OG. Tumors of the jaw, odontogenic tissues and maxillary antrum (excluding Burkitt lymphoma) in Uganda Africans. Cancer. 1965;18:205–15.

    Article  CAS  Google Scholar 

  16. Buchner A, Merrell PW, Carpenter WM. Relative frequency of central odontogenic tumors: a study of 1,088 cases from Northern California and comparison to studies from other parts of the world. J Oral Maxillofac Surg. 2006;64:1343–52.

    Article  Google Scholar 

  17. Ord RA, Blanchaert RH Jr, Nikitakis NG, Sauk JJ. Ameloblastoma in children. J Oral Maxillofac Surg. 2002;60:762–70; discussion 770–1.

  18. Tatapudi R, Samad SA, Reddy RS, Boddu NK. Prevalence of ameloblastoma: a three-year retrospective study. J Indian Acad Oral Med Radiol. 2014;26:145–51.

    Article  Google Scholar 

  19. Ngwenya SP, Raubenheimer EJ, Noffke CE. Internal morphology of ameloblastomas: a study of 24 resected specimens. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:754–62.

    Article  Google Scholar 

  20. Gardner DG. Critique of the 1995 review by Reichart et al. of the biologic profile of 3677 ameloblastomas. Oral Oncol. 1999;35:443–9.

    Article  CAS  Google Scholar 

  21. Li TJ, Browne RM, Matthews JB. Expression of proliferating cell nuclear antigen (PCNA) and Ki-67 in unicystic ameloblastoma. Histopathology. 1995;26:219–28.

    Article  CAS  Google Scholar 

  22. Sah P, Menon A, Kamath A, Chandrashekar C, Carnelio S, Radhakrishnan R. Role of immunomarkers in the clinicopathological analysis of unicystic ameloblastoma. Dis Markers. 2013;35:481–8.

    Article  Google Scholar 

  23. Cottom HE, Bshena FI, Speight PM, Craig GT, Jones AV. Histopathological features that predict the recurrence of odontogenic keratocysts. J Oral Pathol Med. 2012;41:408–14.

    Article  Google Scholar 

  24. Al Qahtani K, Alkhudhayri AF, Islam T, Al Mufargi K, Al Shakweer W, Otaibi F. Recurrent unicystic maxillary ameloblastoma presenting as unilateral proptosis. Saudi J Ophthalmol. 2019;33:94–8.

    Article  CAS  Google Scholar 

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Correspondence to Deepak Pandiar.

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The manuscript includes the data from the archival medical records of four teaching schools with no additional psychological, physical and financial burden for the patient.

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Anand, R., Narwal, A., Pandiar, D. et al. Clinicopathological Profile of 80 Cases of Unicystic Ameloblastoma Aided by a Histopathological Comparison Using Modified Philipsen–Reichart Classification and Marx–Stern Classification. Head and Neck Pathol 15, 875–881 (2021). https://doi.org/10.1007/s12105-021-01307-7

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