Giant ameloblastoma

Abstract

Ameloblastoma is an odontogenic tumor of epithelial origin that can be locally aggressive. These tumors do not normally reach sufficient size to qualify as a giant ameloblastoma mandible as which the patient seeks medical attention before this stage. We report the case of a 33-year-old male who had a giant ameloblastoma of the mandible due to its rarity, size, and management in developing countries. It is probably the largest reported case in the world as per literature. The tumor measured a size of 30 cm × 18 cm × 12 cm involving bilateral ramus, angle, body, and symphysis of the mandible. Computed tomography scan showed a well-defined, multiloculated cystic lesion arising from the entire mandible. Such cases require a total mandibulectomy with osseocutaneous free-flap reconstruction and physiotherapy for rehabilitation. However, in most of the scenarios in rural India, there are limited facilities, and due to poor socioeconomic status, a free flap with phased remodeling is not possible. Hence, in this particular scenario, we performed total mandibulectomy with pectoralis major myocutaneous (PMMC) flap reconstruction followed by physiotherapy and rehabilitation to achieve near-normal life. Therefore, a total mandibulectomy followed by a pedicled PMMC flap reconstruction is a good alternative option in a resource-limited setting.