Ameloblastoma — ORE Part 1 MCQ

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HardOral PathologyAmeloblastomaORE Part 1

A 25-year-old patient presents with a painless, slow-growing swelling in the right posterior mandible. An OPG shows a multilocular radiolucency with a soap-bubble appearance. The inferior alveolar canal is displaced inferiorly. What is the most likely diagnosis?

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Correct answer: E — Ameloblastoma

The combination of multilocular soap-bubble radiolucency, posterior mandibular location, painless slow growth, and notably the inferior displacement of the inferior alveolar canal strongly indicates ameloblastoma. Follicular ameloblastomas characteristically present with this radiographic appearance and typically arise in the molar-ramus region. Although odontogenic keratocyst can also present with multilocular soap-bubble radiolucency, ameloblastoma's more aggressive expansion pattern causes greater inferior displacement of the inferior alveolar canal. Dentigerous cysts are typically unilocular and associated with impacted teeth (not mentioned here). Radicular cysts are unilocular and periapical. Central giant cell granuloma more commonly affects the anterior mandible. Histopathological confirmation is essential, but the radiographic presentation makes ameloblastoma the most likely diagnosis.

Reference: Abdi I, et al. The effect of ameloblastoma and keratocystic odontogenic tumor on the displacement pattern of inferior alveolar canal in CBCT examinations. Journal of Dental Research, Dental Clinics, Dental Prospects. 2016;10(3):155-161. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5025216/