The Role of Radiotherapy in the Management of Recurrent Mandibular Ameloblastoma: A Case Report and Literature Review

Abstract

Introduction. Ameloblastoma is a rare, aggressive odontogenic tumor characterized by a high risk of recurrence. Although radical surgical resection remains the primary treatment modality, surgical intervention may become unfeasible in cases of multiple recurrences and tumor infiltration into vital structures. In such instances, radiotherapy serves as a significant therapeutic alternative. Case report. We present the case of a patient diagnosed with a multicystic-solid type ameloblastoma of the mandible. Over a 10-year period following the initial diagnosis, the patient underwent 5 surgical interventions due to persistent recurrences and tumor extension into the infratemporal fossa, masticatory muscles, parotid salivary gland and other head and neck structures. Upon the diagnosis of a further recurrence with invasion into the skull base and near major blood vessels, radical surgery was contraindicated due to life-threatening risks. The patient was treated with volumetric modulated arc therapy to a total dose of 60 Gy. Post-treatment evaluation revealed complete tumor regression. At the 4-year follow-up after radiotherapy, the patient remains in remission. Conclusion. Volumetric modulated arc therapy is an effective treatment for locally advanced, unresectable, and recurrent ameloblastomas, enabling long-term remission while minimizing toxicity to surrounding healthy tissues.