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Diagnosed with Ameloblastoma

Head & Neck Cancer | Last Active: Oct 28 6:03pm | Replies (227)

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@lesleylbrown

@tomschwerdt I would definitely be interested to read your argument about the misclassification of ameloblastoma being label a "non cancer". Is there a specific time frame I can search for this information within the forum? Also, I am very interested to get a referral to MDA. I'm hoping I can get approval for this as he does have medicaid for insurance.

And thank you and @anbar04 for the advice on the surgery!

Just an update on what's been going on-

We were initially told that he had an ameloblastoma in the middle of his lower jaw, which, from what I understand, is an unusual site for this type of tumor. After that, we were referred to UTMB, where the oral surgeon suggested that it was just a cyst. We felt a lot of relief when a CT scan also noted it as a "cystic lesion."

Yesterday, we went in for surgery to remove the cyst and the adult tooth that was believed to have caused it. However, after the surgery, the surgeon informed us that it does look more like a tumor after all. So, we're back to square one with the tumor diagnosis, and it has been sent off for a biopsy.

I’m trying to stay hopeful, but I’ve read that ameloblastomas can sometimes appear benign under the microscope, even when they aren't technically benign. Does anyone know if that's true? Also, my son is quite young to have developed this, and the location of the mass seems a bit unusual. Because of these anomalies I'm quite worried about the type of ameloblastoma we are dealing with.

That being said, we’re grateful that the mass has been removed, and an extra adult tooth was saved during the surgery. He’s less than 24 hours post-op and is doing really well. His pain is being managed, and he's recoveringtomschwerdt for the advice on the surgery!

Just an update on what's been going on-

We were initially told that he had an ameloblastoma in the middle of his lower jaw, which, from what I understand, is an unusual site for this type of tumor. After that, we were referred to UTMB, where the oral surgeon suggested that it was just a cyst. We felt a lot of relief when a CT scan also noted it as a "cystic lesion."

Yesterday, we went in for surgery to remove the cyst and the adult tooth that was believed to have caused it. However, after the surgery, the surgeon informed us that it does look more like a tumor after all. So, we're back to square one with the tumor diagnosis, and it has been sent off for a biopsy.

I’m trying to stay hopeful, but I’ve read that ameloblastomas can sometimes appear benign under the microscope, even when they aren't technically benign. Does anyone know if that's true? Also, my son is quite young to have developed this, and the location of the mass seems a bit unusual. Because of these anomalies I'm quite worried about the type of ameloblastoma we are dealing with.

That being said, we’re grateful that the mass has been removed, and an extra adult tooth was saved during the surgery. He’s less than 24 hours post-op and is doing really well. His pain is being managed, and he's recovering!

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Replies to "@tomschwerdt I would definitely be interested to read your argument about the misclassification of ameloblastoma being..."

Hey, @lesleylbrown

Ameloblastomas are usually benign. My understanding is that they used to be classified as a cancer, and were reclassified because of they are usually benign. "Benign but locally aggressive" is how it was originally described to me. Uncontrolled growth of cells, destroying healthy tissue locally.

However, in a small percentage of cases ameloblastoma can metastasize (invade other parts of the body) - which is the hallmark of a tumor being a cancer instead of being benign.

My understanding is that in the times it does metastasize, it's usually an ameloblastoma which has been allowed to grow enormous without treatment.

However, to know this you have to dig deep into the topic.

Most doctors will never encounter an ameloblastoma in their career. Even many oral surgeons won't ever encounter one - and oral surgeons are the ones treating the vast majority of ameloblastomas which get treatment. Dentist discovers it, refers you to the oral surgeon, who performs the standard treatment of surgery. Virtually no oncologists ever see ameloblastomas, so why would they know much about them?

Expect that the standard pathologist will end up unable to decide if it's ameloblastoma, then refer the biopsy analysis to a specialty pathologist who will take a month or more and several reminders to finalize the report. At least, that's how it happened for me both times.

Now, for the good news: It sounds like the growth/tumor/whatever was relatively small. If it is an ameloblastoma - they usually grow pretty slowly. My original tumor was removed with relatively conservative surgery (enucleation and curettage) and it was ~15 years before it showed up on a dental Xray.

In those intervening 15 years, it was determined that ~80% of mandibular (jawbone) ameloblastomas have the BRAF V600E mutation, and the FDA approved a drug treatment for tumors with that specific mutation.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/braf-mutation-and-cancer