Clinical and demographic characteristics in ameloblastoma patients: A single-center study.

Abstract

e18146 Background: Ameloblastomas account for 13-58% of odontogenic tumors. They can be unicystic, extraosseous/peripheral, or metastatic. Treating an ameloblastoma involves surgically removing the tumor and performing reconstruction at the same time. These tumors are locally aggressive, have high recurrence rates, and can metastasize at a rate of 1%. Treating ameloblastoma remains challenging due to its high recurrence rate and extensive tissue defects. Recent molecular advances strongly indicate the potential for targeted therapy with better outcomes in ameloblastomas. These tumors often have mutations in genes within the mitogen-activated protein kinase (MAPK) pathway. About 96% of ameloblastomas with BRAFV600E mutations are found in the mandible. There have been reports of notable treatment responses using dual BRAF/MEK inhibitors, dabrafenib and trametinib, in patients with multiple lung metastases. This study aimed to explore the demographic and clinicopathological characteristics of patients with ameloblastoma. Methods: In our study, patients diagnosed at Çukurova University between 2010 and 2023 were included, and data from 78 treated patients were retrospectively analyzed. Patient age, gender, tumor location, histological subtypes, presence of recurrence, BRAF mutation, and Ki67 value were recorded. Results: Among the patients, 51.3% (40) were male and 48.7% (38) were female. The median age at diagnosis for patients was 35 years (range 12-70 years). Tumors were located in the mandible in 69 patients and in the maxilla in 9 patients. There are 17 patients with unicystic, 4 with desmoplasty, 2 with intracystic intraluminal conditions, 1 with multicystic, and 4 with solid ameloblastoma histology. BRAF mutation was tested in seven patients, and it was found in five. One patient received BRAF-targeted therapy for metastatic disease. 7 patients experienced a recurrence of the disease during follow-up. Discussion: Ameloblastoma more commonly occurs in the mandible, but it can also be found in the maxilla. In our study, 88% of the patients had the tumor localized to the mandible. In our study, the unicystic type made up 21% of the patients and was the most frequently identified histological subtype. The BRAF mutation is the most frequently identified mutation in patients with ameloblastoma. In our study, we examined the BRAF mutation in 7 patients, and a BRAF mutant was found in 5 of them. The BRAF mutation might be linked to the frequency of recurrence and metastasis occur. Conclusions: Limited data exist on factors affecting the recurrence of ameloblastoma, a locally aggressive odontogenic tumor, and on treatments for metastatic disease. Our focus was to review current treatment methods and emerging strategies by analyzing the demographic and clinicopathological characteristics of ameloblastoma patients.