Clinicopathological and Radiographic Patterns of Pediatric Ameloblastoma in Lagos, Nigeria

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Background: Pediatric ameloblastoma is an uncommon odontogenic tumor that demonstrates clinicopathologic characteristics distinct from adult cases. Precise delineation of demographic distribution, anatomic predilection, radiographic presentation, and histopathologic subtypes is essential for risk-adapted surgical planning and improved long-term outcomes. Objective: To characterize the demographic, clinical, radiographic, and histopathological features of ameloblastoma in children and adolescents treated at a tertiary referral center in Lagos State, Nigeria, and to evaluate predictors of biologic tumor type. Methods: A retrospective cross-sectional study was conducted among 63 patients ≤ 18 years diagnosed with ameloblastoma between 2013 and 2025. Data collected included age, sex, duration of symptoms, tumor site, radiographic appearance, and histopathologic classification according to the 2022 WHO criteria. Associations between biologic type [unicystic vs. conventional] and clinical variables were examined using chi-square or Fisher’s exact tests. Binary logistic regression analysis was performed to identify independent predictors of conventional ameloblastoma among 59 cases with specified classification. Results: The majority of patients were aged 11–15 years [42.9%], followed by 16–18 years [38.1%]; no cases occurred below 6 years. Males predominated [63.5%]. Tumors overwhelmingly involved the mandible [90.5%], with maxillary lesions accounting for 3.2%. Conventional ameloblastoma constituted 49.2% of cases, unicystic ameloblastoma 44.4%, and 6.3% were unspecified. Plexiform architecture predominated among conventional tumors [25.4% of total cohort], whereas the mural variant was most frequent among unicystic lesions [22.2%]. Radiographic appearance demonstrated a strong association with biologic type: 96.4% of unicystic tumors were unilocular, while 96.8% of conventional tumors were multilocular [p < 0.001]. On multivariable analysis, increasing age [OR 1.328 per year; 95% CI 1.067–1.654; p = 0.011], male sex [OR 4.208; 95% CI 1.516–11.681; p = 0.006], and multilocular radiographic pattern [OR 133.2; 95% CI 12.61–1407.3; p < 0.001] independently predicted conventional ameloblastoma. Duration of symptoms was not significantly associated with biologic type. Conclusion: Pediatric ameloblastoma in this cohort demonstrated teenage predominance, significant male preponderance in conventional tumors, and marked mandibular localization. Conventional ameloblastoma slightly exceeded unicystic ameloblastoma. Multilocular radiographic appearance, older age, and male sex were strong independent predictors of conventional histology. These findings underscore the importance of integrating demographic and imaging features with histopathologic classification to guide surgical decision-making in pediatric patients.

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