Ameloblastoma of the Nasal Septum Origin: A Case Report

Background. Ameloblastoma is the most common odontogenic tumor. It represents about 1% of all tumors of the jaw. Extragnathic location of the ameloblastoma is typical and extremely rare. Case Report. We report a case of ameloblastoma of the nasal septum origin, causing nasal obstruction. According to our information, this is the first reported case of ameloblastoma coming from the nasal septum as a primary tumor without maxillary sinus involvement. Conclusions. Ameloblastoma can not only locate in the maxilla and mandible, but also in other regions of the craniofacial. Ameloblastoma should be considered in the differential diagnosis of tumors causing nasal obstruction. Nonspecific clinical features of sinonasal ameloblastoma make it extremely important to perform accurate diagnostic imaging and histopathological examination. 1. Introduction Ameloblastoma is the most common odontogenic tumor. It represents about 1% of all tumors of the jaws [1]. It occurs four times more often in the mandible than in the maxilla; a variety of peripheral locations are also listed. Ameloblastoma is a benign epithelial tumor, derived from the residual dental lamina or from the developing enamel organ. This neoplasm usually does not cause pain and grows slowly, causing the distension of the bone. Ameloblastoma may be locally invasive—can invade the surrounding tissues—giving frequent recurrence after nonradical surgery (45–90%). Rare forms of malignant ameloblastoma-carcinoma ameloblasticum can occur. Then it may give distant metastases to the lungs, lymph nodes, and spine [2, 3]. Macroscopic appearance of ameloblastoma is usually a cavernous tumor, cushioned with a thin lining, sometimes without tumor capsule, filled with gray-white or gray-pink gelatinous mass. The microscopic examination reveals focuses of epithelial tissue and mimicking enamel organ, surrounded by mature connective tissue rich in collagen. The tumor shows a considerable variety in radiological imaging—presenting a view of one or more multi-cave cysts—sometimes containing a primordial tooth or images of soap bubbles, honeycomb, or solid tumor appearance [4]. Usually ameloblastoma is diagnosed late, in advanced stages, due to its long and scantily-symptomatic development. Wide surgical excision of the tumor in the normal tissue margin is considered to be the treatment method of choice. Ameloblastomas developed in the maxilla can secondarily grow in the nasal cavity and paranasal sinuses, but the primary focus of ameloblastoma in this area, with no relation to the jaw area, is extremely rare. There are only