Late Extraosseous Recurrence of Plexiform Ameloblastoma Presenting with Airway Compromise: A Case Report.

Ameloblastoma is a benign but locally aggressive odontogenic tumor with a high recurrence potential. Extraosseous recurrence is rare and may pose diagnostic and therapeutic challenges. We report a case of late extraosseous recurrence of plexiform ameloblastoma presenting with airway compromise in a 50-year-old male, 8 years after segmental mandibular resection and reconstruction. The lesion occupied the floor of the mouth and right submandibular space, producing tongue displacement and significant airway narrowing without radiological evidence of osseous involvement. Due to anticipated airway difficulty, a prophylactic tracheostomy was performed. Complete excision was achieved via a transcervical approach. Histopathology confirmed plexiform ameloblastoma. The patient recovered uneventfully and was decannulated on postoperative day 2. This case highlights the importance of long-term surveillance, adequate soft-tissue clearance, and proactive airway management in recurrent ameloblastoma.