Byline: Mark. Nwoga
Background: Ameloblastoma is a benign cystic odontogenic tumor common in Nigeria. The cystic cavities frequently contain tumor fluids, which may be obtained by needle aspiration. The tumor fluids help in the clinical differential diagnosis. The types, prevalence, and relevance of ameloblastoma fluid aspirates have been mostly unreported. Objectives: The aim of this study was to identify the types and prevalence of fluid aspirates of ameloblastoma and evaluate its prognostic relevance. Materials and Methods: This was a 7-year retrospective study of consecutive patients with ameloblastoma at a tertiary hospital in Enugu, Nigeria. The tumor fluids obtained by needle aspiration are categorized based on visual appearance. The data retrieved from case files, biopsy forms, histopathologic reports, and other records in the departmental archives were analyzed with IBM SPSS Statistics, version 24.0. Results: Tumor fluid aspirate yield was positive in 80.4% ((n=74) of patients with ameloblastoma. There were aspirates from 82.4% (n=61) cases of primary ameloblastoma and 17.6% (n=13) cases of recurrent ameloblastoma. The aspirates obtained were dark-brown 41.9%, straw-colored 37.8%, serosanguinous 10.8%, and purulent 9.5%. The type of aspirate was influenced by the primary or recurrent status of ameloblastoma (P = 0.04). Straw-colored aspirate was obtained from 92.9% of primary ameloblastoma and in 73.1% of patients <20 years of age. Recurrent ameloblastoma typically yielded dark-brown aspirates in 76.9% of recurrences. Conclusion: The association of some tumor fluids with primary and recurrent ameloblastoma could improve the understanding of the recurrence potential of the disease and influence treatment planning.
Introduction
Ameloblastoma is a benign, epithelial jaw tumor commonly diagnosed as peripheral, unicystic, multicystic, and metastasizing.[1] It has been reported as the most frequently diagnosed odontogenic tumor in Nigeria.[2] The tumor is mostly slow-growing but could present with large disfiguring jaw swellings, malocclusion, loosening of teeth, buccal and lingual bone expansion, cortical perforation with soft-tissue invasion, and unilocular or multilocular radiolucency.[1] Intraosseous ameloblastoma could present with cystic cavities which develop from degenerations of epithelial tumor islands.[1] Jaw swellings often prompt clinicians to perform chair-side needle aspirations to exclude or affirm its solid, cystic, or vascular nature. Such simple clinical procedures result in positive or negative tumor fluid yields.[3]
Visual examinations of fluid aspirates from tumors histologically diagnosed as ameloblastoma have been variously described as straw-colored,[4] brownish,[5] blood-tinged straw-colored,[6] straw fluid,[7] and brownish-yellow.[8],[9]
Few studies known to the author and in English literature have investigated the types, prevalence, categories, and prognostic relevance of ameloblastoma tumor fluids.[5],[6],[8],[9] A most recent report of ameloblastoma in children and adolescents only categorized the types of tumor fluid aspirates as straw, serosanguinous, dark-brown, and purulent.[10] There is a possibility that fluids obtained from ameloblastoma could give insight into its biological behavior and guide management. This study evaluates the types, frequency, and prognostic relevance of the fluid aspirates of primary and recurrent ameloblastoma.
Materials and Methods
This was a retrospective review of consecutive patients who presented at the Oral and Maxillofacial Surgery/Pathology clinics with histologically confirmed diagnoses of ameloblastoma from 2012 to 2018.
The archived records of case files,...