Extreme ameloblastoma of the mandible with hypoproteinemia. A case report and review of clinicopathological features

Ameloblastoma is a tumor of odontogenic epithelium. It has an intermediate malignant potential, thus positioning it in a gray zone between benign and malignant neoplasms. Invasive ameloblastomas of excessive size are rarely confronted. Although these ameloblastomas are benign, they are life threatening. Many have eventuated in death due to airway obstruction, starvation from restriction of feeding, and complications of hypoproteinemia. These tumors cause significant expansion of skin and lips [tissue expanders]. Due to its metabolic demands, a tumor of enormous size will have numerous feeding vessels. Patients with extreme ameloblastomas are usually from rural areas of developing countries who delay the treatment due to fear of surgery. We present a case of extreme ameloblastoma in a 35 year old female which was a consequence of patient negligence. The tumor reached an enormous size over 10 years causing gross facial deformities and posed considerable problems in management.