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Introduction: Ameloblastoma is a very rare benign tumor with tendency to recur after surgical excision. Although it is the most common odontogenic tumor, it comprises only 1% of all tumors of the maxilla and mandible.
Case Report: This is a case of a sinonasal ameloblastoma in a 55-year-old man who presented with a 5-month history of unilateral nasal blockage and progressive painless swelling of the left maxilla. CT and MRI scans showed a solid mass filling the left maxillary sinus with evidence of bony erosion of the anterior and medial walls of the sinus, extending to the premaxillary soft tissues, the nasal cavity, the left ethmoid and frontal sinuses, the sphenoid sinus, and the nasopharynx. The tumor was excised via a lateral rhinotomy approach and the histology report was of a mainly plexiform sinonasal ameloblastoma with both solid and glandular areas. The patient remains free of recurrent disease 9 months postoperatively. A review of histological features, clinical course, differential diagnosis, radiographic appearance, and treatment modalities is presented.
Conclusion: Sinonasal ameloblastomas should be in the differential diagnosis of any nose lesion especially when there is tooth involvement and opacification of the maxillary sinus. Their tendency to recur and in some cases to metastasize makes a wide excision, with or without postoperative radiotherapy, the treatment of choice especially for malignant cases. In addition, long-term follow-up is essential because there are some reports of late recurrences.