A giant adenomatoid odontogenic tumor of the mandible: A case report and literature review

Int J Surg Case Rep. 2022 Jul:96:107295. doi: 10.1016/j.ijscr.2022.107295. Epub 2022 Jun 10.

Abstract

Introduction and importance: An adenomatoid odontogenic tumor is a rare medical condition. Large tumor (or several) often appears in the maxillae. In a minority of cases, the tumor(s) appear in the mandible.

Case presentation: We report on a case of a 24-year-old female diagnosed with a mandibular adenomatoid odontogenic tumor, a giant tumor measuring approximately 22 × 25 × 17 cm. The tumor was located on the side of the mandible, causing facial deformity, malnutrition, and hemorrhaging. We assessed the patient's overall condition, carried out a resection of the tumor and mandible from the right condyle to the left mandibular angle, and reconstructed the mandibular defect with a fibula free flap. After the treatment, the patient was followed up for 1 year, with no recurrence detected over this period.

Clinical discussion: Because adenomatoid odontogenic tumors are benign odontogenic lesions, which are painless and slow-growing, most are surgically removed or treated conservatively. However, the above treatment measures cannot be applied in the case of a giant tumor that causes facial deformity, destroys the entire jawbone, and has complications such as hemorrhaging and malnutrition. After the tumor resection, the defect is still significant. Accordingly, reconstruction using a microsurgical bone flap is an effective method instead.

Conclusion: Large adenomatoid odontogenic tumors in the mandible are rare, and treatment cannot follow conventional methods. Accordingly, defect reconstruction after tumor resection is essential.

Keywords: Adenomatoid odontogenic tumor; Case report; Fibula flap; Mandibular.