gms | German Medical Science

67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

Intracranial Ameloblastoma arising from the maxilla: an interdisciplinary surgical approach

Meeting Abstract

  • Johanna Quick-Weller - Department of Neurosurgery, Goethe University Frankfurt, Germany
  • Felix Koch - Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Goethe University Frankfurt, Germany
  • Peter Baumgarten - Edinger Institute, Neurological Institute, Goethe University Frankfurt, Germany
  • Gerhard Marquardt - Department of Neurosurgery, Goethe University Frankfurt, Germany
  • Volker Seifert - Department of Neurosurgery, Goethe University Frankfurt, Germany
  • Thomas M. Freiman - Department of Neurosurgery, Goethe University Frankfurt, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocP 018

doi: 10.3205/16dgnc393, urn:nbn:de:0183-16dgnc3933

Published: June 8, 2016

© 2016 Quick-Weller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Ameloblastomas are a rare tumor entity accounting for only 10% of all odontogenic tumors. They mostly originate from the mandible. Only few cases are known to grow aggressively and to invade the orbit, nasal cavity or even the brain.

Method: We hereby present the case of a 57-year-old patient who was admitted with a huge tumor involving the nasal cavity, the let maxilla and the anterior fossa. Histological diagnosis was made by biopsy. In a next step a combined, two staged neurosurgical-maxillo-facial approach was planned.

Results: First the intracranial tumor mass was removed by using a bifrontal trepanation. A dura plastic was sewn in to cover the brain. In a second procedure a combined bifrontal and midfacial approach was used by craniofacial-plastic-surgeons and neurosurgeons. Parasinusoidal tumor mass and retropharyngeal tumor mass was removed until reaching the skull base. The left orbit was completely exonerated and a fibular bone-muscle graft was used for palatinal, orbital and facial reconstruction. Facial vein and artery were carefully prepared to feed the bone-muscle graft by end-to-end anastomoses.

Conclusions: Ameloblastomas are very rare tumors which are slowly growing but show a tendency to recur. They are responsible for only 1% of all oral tumors. Their growth can be enormous and they can extend into sinusoidal cavities, the orbit and the brain. Complex and extensive surgery as a palliative setting can ease complaints of these patients and prolong their survival.