JVD 2020 #1 Presentation, Diagnostic Imaging, and Clinical Outcome of Conventional Ameloblastoma in Dogs; Tjepkema Flashcards

1
Q

What are the cytologic features of ameloblastomas?

A

Differentiated ameloblasts (cells that produce enamel) and/or enamel organ differentiation but do not induce differentiation of odontogenic mesenchyme (ie no induction of the dental papilla or tooth-like structures)

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2
Q

Where is the ameloblastoma neoplastic epithelium assumed to arise from?

A

Previously quiescent remnants of odontogenic epithelium that remain within the periodontium.
For centrally located (within the jaw bone)- likely arise from rests of Malassez or other entraped/ectopic remnant of enamel organ.
For peripherally located (ie within gingiva) likely arise from rests of Serres

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3
Q

What are the 4 biologic subtypes of ameloblastoma in humans?

A

Peripheral- least aggressive, no bone involvement
Desmoplastic (1 case in dog)
Unicystic- (not reported in animals)
Solid/multicystic- variants: follicular, plexiform and acanthomatous

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4
Q

What was the mean/median age of dogs that had conventional ameloblastoma in the study?

A

8.9/9 years

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5
Q

How did conventional ameloblastoma present clinically- appearance?

A

A mass causing focal swelling and expansion within the jaw. The tumors often had a smooth surface of intact gingiva and/or mucosa with occasional fluctuant and dark-purple-blue cystic areas.

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6
Q

What was the most common area affected?

A

Maxilla (13/20) compared to 7/20 mandible. Most in the canine/premolar region

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7
Q

In those cases with diagnostic imaging available, what were the key features noted?

A

Loculated intraosseous lesion
Cystic features- central radiolucency with corticated border 11/13 cases.
More often a multicystic/multilocular pattern on rad and CT
Jaw bone lysis in 4/6 CT studies
Mixed lytic/proliferative pattern
External tooth resorption
Contrast enhancement in all cases with CT

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8
Q

Histopathology of canine conventional ameloblastoma

A

Neoplastic odontogenic epithelium without induction of odontogenic mesenchyme or formation of tooth structures.
Odontogenic epith. had recognizable ameloblast-like cell morphology: tall cuboidal to columnar layer of basal cells with palisaded nuclei in the apical cytoplasm
Histo patterns seen similar to humans: basal, plexiform and follicular

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9
Q

What was the treatment and outcome for cases in the study?

A

Most had wide surgical excision (17/20) and none had regrowth.
Half had narrow margins <0.5cm on histo

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