Maxillary Ameloblastoma: A Case Report of a Rare Tumor and a Brief Review of the Literature

Ameloblastoma is a benign yet locally aggressive odontogenic tumor, with the maxillary presentation being a rare and clinically challenging entity due to its proximity to vital midfacial structures and tendency for silent, rapid expansion. This report detailed the case of a 23-year-old female who presented with an eight-month history of progressive left-sided facial swelling and subsequent infraorbital nerve paresthesia, initially misdiagnosed as a dental issue. Key diagnostic findings included a large, expansile, multilocular radiolucent lesion on panoramic and CT imaging, exhibiting the classic "soap bubble" appearance. Histopathological examination confirmed the diagnosis of conventional (multicyclic) ameloblastoma, follicular subtype, characterized by islands of odontogenic epithelium with peripheral palisading and reverse polarity.

The management involved a radical infrastructure maxillectomy with histologically confirmed negative margins, followed by immediate microvascular reconstruction using a vascularized fibular free flap. The patient achieved an excellent functional and aesthetic outcome, with no evidence of local recurrence at the three-year follow-up. This case underscores the critical importance of maintaining a high index of suspicion for persistent midfacial swellings. It validates the use of radical surgical resection combined with immediate microvascular reconstruction as the gold standard for achieving oncological safety and optimal quality of life in young patients with extensive maxillary ameloblastoma.