Surgical treatment of mandibular ameloblastoma with radical mandibulectomy and free fibular reconstruction: a case report

Abstract

Introduction: Ameloblastoma is an odontogenic tumor that represents 1% of all tumors in the oral cavity.
It is a benign tumor and it occurs in all age groups with the same frequency in men and women, the location
is 80% - 20% in the jaw and maxillary, respectively. The origin can be the embryonic remains of odontogenic

cysts, the dental sheet, the enamel organ or the stratified squamous epithelium of the oral cavity. The
etiology is unknown. The tumor is usually asymptomatic, painless, and present with bony deformity. Wide
surgical excision with adequate safe margins is the treatment of choice. Segmental resection of mandible
was done with immediate reconstruction plates.
Purpose: To describe on case of extensive mandibular ameloblastomas treated with mandibulectomy
and immediate reconstruction by free fibula flap and rehabilitation with delayed endosteal dental implants.
Materials and Methods: one case of recurrentameloblastoma tumor in younger patient who has been
treatedwith surgery at the Odonto-Stomatology Center of Hue central hospital. A31-year-old male patient
previously treated with enucleation who had tumor relapse after 8 years. There was the invasion of the
tumor to the entire mandibular body on CT Scan. The result of histopathologywas ameloblastoma. The
surgical plan included complete resection of the tumor, which was followed by immediate reconstruction
using an osteocutaneous free fibularflap.
Results: Flap was transplanted successfully, and no major complication occurred postoperatively. Free
margin was achieved in patient. There were no clinical or radiologic signs of recurrence after 1-year follow-up.
Conclusion: Segmental mandibulectomy followed by immediate defect reconstruction with free fibular
flap should be considered as the treatment of choice for extensive mandibular ameloblastoma.
Key words: Ameloblastoma, mandible, fibular flap

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Published 24-02-2025
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Issue No. 55 (2019)
Section Original article
DOI
Keywords : U men nang, xương hàm dưới, vạt xương mác : Ameloblastoma, mandible, fibular flap

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Loi, N. H., Dung, N. viet, Chau, H. L. T., Phu, T. X., & Khanh, N. V. (2025). Surgical treatment of mandibular ameloblastoma with radical mandibulectomy and free fibular reconstruction: a case report. Journal of Clinical Medicine Hue Central Hospital, (55), 73–79. Retrieved from https://jcmhch.com.vn/index.php/home/article/view/2039