AMELOBLASTOMA

I first met this patient in 2004. He had a massive jaw tumor that had been growing for more than a decade. He had a previous surgery but the tumor recurred and he gave up hope of a cure. 


The tumor was an ameloblastoma, a neoplasm of odontogenic origin (referring to teeth formation) that expands the mandible (jaw) from the inside out (see the CT of another patient with a similiar problem-our patient could never afford a CT). Some studies suggest that this tumor is more common in West African males.


In our patient's case, the hollowed out mandible became infected and developed a sinus to the skin (see the lowest portion of the chin). Every time he coughed or sneezed, pus would gush out of the sinus. It was a terrible way to live.

Intraoperative photo after removal of the right mandible

      




We resected the tumor, which required removing half of his mandible, and did a pectoralis major muscle flap to help with reconstruction and closure. He is still doing well, without recurrence, as of July, 2011.

An interesting aside, to this wonderful story, is that the patient's daughter went to medical school. She had financial difficulties and almost had to quit. Earthwide Surgical Foundation supported her education. She completed medical school in 2010.