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− | Also known as: '''''Acanthomatous Epulis — Peripheral Ameloblastoma — Basal Cell Carcinoma — Adamantinoma
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− | ==Description==
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− | [[Image:ameloblastoma.gif|right|thumb|125px|<small><center>Ameloblastoma (Courtesy of Alun Williams (RVC))</center></small>]]
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− | 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.
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− | ==Signalment== | + | ==Typical Signalment== |
− | Common oral tumour in dogs but rarely occurs in cats. | + | *Common oral tumour in dogs but rarely occurs in cats |
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| + | ==Description== |
| ==Diagnosis== | | ==Diagnosis== |
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| ===Clinical Signs=== | | ===Clinical Signs=== |
− | Include halitosis, oral bleeding, dental disruption or loss, facial or mandibular deformity, excessive salivation, growth protruding from the mouth and rarely dysphagia.
| + | *halitosis |
− | | + | *dysphagia |
| + | *bleeding |
| + | *growth protruding from the mouth |
| ===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>.
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| ===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.
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− | '''Pathology''':
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− | 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.
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| ==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.
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| ==Prognosis== | | ==Prognosis== |
− | Good following complete surgical excision.
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− | {{Learning
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− | |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]
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− | |Vetstream = [https://www.vetstream.com/felis/Content/Disease/dis02003.asp Mouth neoplasia]
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− | }}
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| ==References== | | ==References== |
− | <references />
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− | Tutt, C., Deeprose, J. and Crossley, D. (2007) '''BSAVA Manual of Canine and Feline Dentistry (3rd Edition)''' ''BSAVA''
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− | Merck & Co (2008) '''The Merck Veterinary Manual'''
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− | With thanks to Andrew Jefferies (Cambridge) and Alun Williams (RVC) for providing access to their lecture materials
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− | {{review}}
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− | {{OpenPages}}
| + | *Tutt, C., Deeprose, J. and Crossley, D. (2007) '''BSAVA Manual of Canine and Feline Dentistry (3rd Edition)''' ''BSAVA'' |
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− | [[Category:Oral_Cavity_-_Proliferative_Pathology]][[Category:Oral Diseases - Dog]]
| + | *Merck & Co (2008) '''The Merck Veterinary Manual''' |
− | [[Category:Neoplasia]]
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− | [[Category:Oral Diseases - Cat]]
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− | [[Category:Expert_Review - Small Animal]]
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− | [[Category:Teeth_-_Proliferative_Pathology]]
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− | [[Category:Oral Proliferations]]
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− | [[Category:LisaM reviewing]]
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