Ameloblastoma — ORE Part 1 MCQ

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HardOral PathologyAmeloblastomaORE Part 1

A 15-year-old girl presents with a painless swelling of the right mandible discovered incidentally on an OPG taken for orthodontic assessment. The radiograph shows a well-defined multilocular radiolucency with fine internal septa giving a 'soap bubble' appearance in the body and ramus. What is the most likely diagnosis?

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Correct answer: C — Ameloblastoma

Ameloblastoma is the most likely diagnosis. The classic presentation comprises: (1) adolescent age (typically 10–20 years); (2) painless unilateral mandibular swelling in the molar-ramus region; (3) well-defined, corticated multilocular radiolucency with characteristic 'soap bubble' or 'honeycomb' internal septa pattern on radiographs. The soap bubble appearance is present in approximately 50% of multilocular ameloblastomas, typically associated with the follicular histological variant. Incidental discovery on OPG is common. Ameloblastoma accounts for ~1% of odontogenic tumours but is the most common odontogenic tumour in developing countries; it is benign but locally aggressive with high recurrence if inadequately treated. Odontogenic myxoma, though multilocular, lacks the characteristic soap bubble pattern. Central giant cell granuloma is usually unilocular and presents in anterior mandible. Aneurysmal bone cyst shows soap bubble but is more rapidly progressive. Ossifying fibroma typically shows mixed radiolucent-radiopaque appearance.

Reference: Multicystic Intraosseous Ameloblastoma With Follicular Pattern in a 16-Year-Old Male: A Case Report. NCBI/PMC. 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356602/