Giant ameloblastomas: clinico-pathological review of implications of tumor growth rate

Introduction
Limited number of publications describe the influence of tumor growth rate on clinicopathologic features of giant (extreme or gigantic) forms of ameloblastoma (GA). This paper explores the relationship between these two factors.

Objectives
To determine the relationship between tumor growth rate of GA and clinico-pathologic factors such as age, gender and histopathologic subtype.

Material and methods
GA cases were selected from the published literature based on the criteria described by Kanoi et al., availability of clinical data, such as age and gender of patient, duration of lesion, and three-dimensional size (volume) of specimen after surgical resection. Data collected were used to calculate individual tumor growth rate using modified formula of Merhara et al. Clinico-pathological features and calculated tumor growth rates were compared with other publications.

Results
In total, 18 reviewed patients were included into this study, from sixteen publications with 17 patients who fitted the selection criteria and one case of GA from our center. There was gender balance (male : female ratio, 1 : 1), with age ranging 19-73 years (mean, 44.2 ± 15.6 years). Mean age of patients with GA was much higher than in non-GA cases, with statistically significant difference (p = 0.02). There was mild positive correlation (r = 0.219) between surgical volume and duration of tumor, but it was not statistically significant (p = 0.382). Mean specific growth rate was 85% ± 40.1%/year (range, 19.9-170%/year). Comparison of SGR with other clinico-pathological parameters of GA revealed no statistical significance.

Conclusions
GA occurred at a higher mean age than other forms, and the mean tumor growth rate was 85% per year. This had no statistical relationship to clinico-pathological characteristics studied.