Management of recurrent ameloblastoma of the jaws; a 40-year single institution experience.

Ameloblastoma is a histologically almost always benign odontogenic tumor with a high rate of recurrence if not removed completely. Therefore, radical surgery is the treatment of choice of a primary ameloblastoma. Of 18 patients with a recurrent ameloblastoma, previously treated by enucleation, radical surgery was deemed impossible in three because of the extent of the tumor or because of a poor general condition of the patient. Of the remaining 15 patients three refused to undergo radical surgery and have been treated for their recurrence by enucleation again. In none of the twelve remaining patients treated by radical surgery a recurrence was observed in a mean follow-up period of 10.5 years. In one of these patients a metastatic cervical lymph node was detected during the primary reconstruction of the mandibular defect. The absence of recurrences in patients treated by radical surgery should be looked at with some reservation, since recurrences may still show up after 10.5 years. The three patients who refused radical surgery all developed one or more new recurrences.