DOI: https://doi.org/10.36347/sasjs.2024.v10i11.026

Pages: 1323-1327

Ameloblastomas are odontogenic tumors that develop from epithelial remnants. They are slow-growing, locally aggressive and have a high recurrence rate, 10 to 20 or even 30 years after initial resection. Recurrence of ameloblastoma may be due to inadequate treatment or to the aggressive nature of the tumor cells, which readily destroy surrounding tissue. We report the case of a 53-year-old patient who had undergone repeated curettage of a mandibular cyst in the setting of ameloblastoma. In 2012, a segmental mandibulectomy with placement of a screw-plate space maintainer had been performed on an outpatient basis. Three years later, he was referred to our department for debricolage of the mandibular plate. He underwent removal of the osteosynthesis material and reconstruction with a fibular free flap. 7 years later, the patient presented with a recurrence of the ameloblastoma, which depended on the remaining parasymphyseal bone and the fibular free flap. The patient underwent a segmental mandibular osteotomy, removing the free fibular graft and the right condyle. The bone deficit was filled by a stent made of surgical cement, mounted on a mini reconstruction plate. Ameloblastoma is a benign tumor. Segmental resection with 2cm margins remains the standard treatment for the multilocular and follicular types. Recurrence on a free fibula flap is uncertain and rare.