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Also known as: '''''Acanthomatous Epulis — Peripheral Ameloblastoma — Basal Cell Carcinoma — Adamantinoma
==Description==
[[Image:ameloblastoma.gif|right|thumb|125px|<small><center>Ameloblastoma (Courtesy of Alun Williams (RVC))</center></small>]]
==Typical Signalment==
This is a benign but locally invasive odontogenic tumour that appears in the [[Gingiva|gingiva]], often surrounding and displacing the adjacent teeth. The lesions have a raised and sometimes cauliflower appearance and are slow growing. Eventually the lesions can become very large and involve the jaw bone.
==Description==
==Signalment==
Common oral tumour in dogs but rarely occurs in cats.
==Diagnosis==
==Diagnosis==
===Clinical Signs===
Include halitosis, oral bleeding, dental disruption or loss, facial or mandibular deformity, excessive salivation, growth protruding from the mouth and rarely dysphagia.
===Diagnostic Imaging===
===Diagnostic Imaging===
Standard [[Skull and Facial Muscles - Anatomy & Physiology|skull]] radiography is often unrewarding and of low diagnostic yield. Skull computed tomography (CT) provides much greater detail and is frequently employed in preoperative planning (in combination with standard dental intra-oral radiographs). Odontogenic neoplasms frequently are found to involve multiple teeth, contrast enhance, involve lysis of the alveolar bone and demonstrate mass-assoicated tooth displacement. Acanthomatous ameloblastomas may appear as extra-osseous or intra-osseous masses; intra-osseous masses are more likely to have mass-associated cyst-like structures and are subjectively more aggressive as compared to extra-osseous acanthomatous ameloblastomas. In many cases mandibular lymphadenopathy is also observed. In cases where a malignant neoplasm is suspected, complete staging should be performed to look for metastatic disease, including 3-view thoracic radiographs (or thoracic CT) and abdominal imaging (abdominal ultrasound or abdominal CT)<ref>Amory JT, Reetz JA, Sanchez MD, et al. ''Computed tomographic characteristics of odontogenic neoplasms in dogs.'' Vet Radiol Ultrasound, Vol. 00, No. 00, 2013, pp 1–12.</ref>.
===Biopsy===
===Biopsy===
Required for a definitive diagnosis and incisional biopsy is the technique of choice. When undertaking cytological or grab procedures it is more difficult to obtain a representative sample.
'''Pathology''':
Islands and sheets of mature odontogenic epithelium within a collagenous fibrous connective tissue stroma of low/moderate cellularity will be noticed. Each of the islands is bounded by a row of tall columnnar cells. These palisading cells exhibit polarisation away from the basement membrane and have cytoplasmic vacuolation. Central cells have a basaloid appearance. The tumour is often infiiltrating into the underlying bone.
==Treatment==
==Treatment==
Surgical resection is the best option with margins of at least 1cm. Radiation therapy may be considered in patients where wide surgical excision is not possible, however there is a risk of malignant transformation of the tumour at a later stage.
==Prognosis==
==Prognosis==
Good following complete surgical excision.
{{Learning
|literature search = [http://www.cabdirect.org/search.html?q=title%3A%28%22Acanthomatous+Ameloblastoma%22%29+OR+title%3A%28%22Acanthomatous+epulis%22%29+OR+title%3A%28%22Peripheral+ameloblastoma%22%29+OR++title%3A%28Adamantinoma%29 Acanthomatous Ameloblastoma publications]
|Vetstream = [https://www.vetstream.com/felis/Content/Disease/dis02003.asp Mouth neoplasia]
}}
==References==
==References==
<references />
Tutt, C., Deeprose, J. and Crossley, D. (2007) '''BSAVA Manual of Canine and Feline Dentistry (3rd Edition)''' ''BSAVA''
Merck & Co (2008) '''The Merck Veterinary Manual'''
With thanks to Andrew Jefferies (Cambridge) and Alun Williams (RVC) for providing access to their lecture materials
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[[Category:Oral_Cavity_-_Proliferative_Pathology]][[Category:Oral Diseases - Dog]]
[[Category:Neoplasia]]
[[Category:Oral Diseases - Cat]]
[[Category:Expert_Review - Small Animal]]
[[Category:Teeth_-_Proliferative_Pathology]]
[[Category:Oral Proliferations]]
[[Category:LisaM reviewing]]