Recurrent Maxillary Ameloblastoma in an Adolescent Treated With Total Maxillectomy and Immediate Vascularized Iliac Crest Free Flap Reconstruction

Ameloblastoma is an odontogenic tumor characterized by local aggressiveness and a high recurrence rate. Maxillary ameloblastoma is relatively uncommon, particularly in adolescent patients, and recurrent lesions present significant challenges in achieving oncologic control while balancing facial growth, function, and aesthetics. The authors report the case of a 13-year-old female with recurrent right maxillary ameloblastoma, 9 years after initial surgical treatment. Radiologic examinations revealed an extensive osteolytic lesion involving the maxillary sinus, lateral wall of the nasal cavity, and the orbital floor. The patient underwent right total maxillectomy, followed by immediate reconstruction using a vascularized iliac crest free flap. The postoperative course was uneventful, with complete flap survival and satisfactory facial contour restoration. This case highlights that radical resection combined with immediate vascularized bone reconstruction may represent a feasible treatment option for selected adolescent patients with recurrent maxillary ameloblastoma.