Introduction

Ameloblastoma is a benign odontogenic epithelial neoplasm characterized by slow growth, local invasiveness, and a marked propensity for recurrence despite its benign histologic appearance. It represents one of the most common clinically significant odontogenic tumors and most frequently involves the mandible [1,2]. Histopathologically, the follicular subtype is among the most frequently encountered variants and has been associated with a greater tendency to recur than certain other patterns, with a recurrence rate of around 29.5% [3,4].

Recurrence of ameloblastoma most commonly occurs within the first five years following treatment; however, delayed recurrence several years or even decades after initial management has been documented [5,6]. Proposed mechanisms include residual microscopic disease, persistence of tumor islands within the adjacent soft tissue or bone, and the lesion's inherently infiltrative growth pattern [7]. Such late presentations highlight the need for prolonged surveillance even in patients who have remained asymptomatic for extended periods.

Diagnosis of recurrent ameloblastoma may be challenging when lesions arise in atypical locations or present predominantly as soft-tissue masses. Cytological investigations may be inconclusive when sampling yields inflammatory, cystic, or reactive components rather than the representative odontogenic epithelium [8]. We report a rare case of follicular ameloblastoma recurring 16 years after hemimandibulectomy, presenting as a preauricular mass associated with a remnant of the coronoid process.