University of Oulu

Zlotogorski-Hurvitz, A, Soluk Tekkeşin, M, Passador-Santos, F, et al. Conceptual changes in ameloblastoma: Suggested re-classification of a "veteran" tumor. Oral Dis. 2021; 00: 000– 000.

Conceptual changes in ameloblastoma : suggested re-classification of a “veteran” tumor

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Author: Zlotogorski-Hurvitz, Ayelet1,2; Tekkeşin, Merva Soluk3; Passador-Santos, Fabricio4;
Organizations: 1Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
2Department of Oral & Maxillofacial Surgery, Rabin Medical Center, Petah Tikva, Israel
3Department of Tumour Pathology, Institute of Oncology, Istanbul University, Istanbul, Turkey
4Department of Oral Pathology, São Leopoldo Mandic Research Center, Campinas, Brazil
5Translational Immunology Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
6Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
7Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
8Cancer Research and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland
9Department of Pathology, HUSLAB, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
10University Central Hospital, Helsinki, Finland
11Institute of Pathology, Sheba Medical Center, Ramat Gan, Israel
Format: article
Version: accepted version
Access: embargoed
Persistent link:
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2022-01-06


Objectives: The merging of ameloblastoma (AM) with mural unicystic ameloblastoma (UAM-M) was suggested by the 2017 WHO based on similar treatment needs. In an international multicenter study, we investigated the characteristics of their merged product (merged-AM) and raised the possibility of unifying AM and UAM (total-AM).

Materials and methods: AM and UAM (luminal/intraluminal/mural), separate and combined, were analyzed for demographic/clinical/radiological features. ANOVA and chi-square tests were followed by univariate and multivariate analyses, and significance was set at p < .05.

Results: The patients’ mean age was 39.6 ± 20.3 years in merged-AM (147 AM, 76 UAM-M), 45.1 ± 19.4 years in AM (p = .009). Merged-AM comprised 51.3% multilocular/48.7% unilocular tumors, AM comprised 72.5%/27.5%, respectively (p < .001). Merged-AM was associated with impacted teeth in 30.8%, AM in 18% (p = .023). The probability of merged-AM for multilocularity increased by 2.4% per year of age (95%CI 0.6–4.2, p = .009). Association with impacted teeth decreased by 7.9% per year of age (95%CI 1.9–14.39, p = .009). Merged-AM did not differ from total-AM (p > .05).

Conclusions: Merged-AM partially differed from AM, but differences appeared to diminish in an age/time-wise manner. Merged-AM and total-AM were nearly indistinguishable. Therefore, AM and UAM may be considered a continuous spectrum of one type of tumor, further necessitating revision of the treatment approaches.

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Series: Oral diseases
ISSN: 1354-523X
ISSN-E: 1601-0825
ISSN-L: 1354-523X
Volume: In press
DOI: 10.1111/odi.13770
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Copyright information: © 2021 Wiley Periodicals LLC. This is the peer reviewed version of the following article: Zlotogorski-Hurvitz, A, Soluk Tekkeşin, M, Passador-Santos, F, et al. Conceptual changes in ameloblastoma: Suggested re-classification of a "veteran" tumor. Oral Dis. 2021; 00: 000– 000, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.