RECURRENT UNICYSTIC AMELOBLASTOMA OF THE MAXILLA

A previously reported unicystic ameloblastoma, showing luminal plexifo rm epithelial proliferation and the presence of small islands of odont ogenic epithelium in the connective tissue of the cyst wall, recurred 5 years after conservative surgery. The tumour was nucleated and since the epithelial islands were confined to its fibrous capsule a conserv ative approach was regarded as adequate. In view of the later experien ce it is now proposed that where cystic ameloblastomas depict epitheli al infiltration into the capsule a second excision be considered and t hat such surgical material be thoroughly examined for signs of epithel ial infiltration. Whatever type of treatment the surgeon decides to pe rform, it is essential to have a long postoperative period of monitori ng. Because the presence of islands of odontogenic epithelium in the c yst wall influences the surgical approach, it is recommended that path ologists carefully examine cystic ameloblastoma surgical specimens for their presence. Multiple, even serial sections are required for such examinations. The pathology report should include a description of the islands with an indication of their site in the capsule of the tumour .