Adenoid ameloblastoma with dentinoid

Abstract

Ameloblastomas seldom cause diagnostic difficulties due to classic histopathological presentations. Adenoid ameloblastoma is a rare variant in this category which can cause problem in diagnosis due to the presence of areas resembling adenomatoid odontogenic tumor (AOT) and occurrence of varying degrees of dentinoid formation. In this article, we report a case of adenoid ameloblastoma with dentinoid, which was diagnosed accurately after the third recurrence. To the best of our knowledge, so far, only 13 cases have been reported of tumors that histologically show features of amelobalstoma and AOT with hard tissue formation. The recurrences were due to under diagnosis of the lesion followed by a conservative treatment.

Keywords: Adenoid ameloblastoma; adenomatoid odontogenic tumor; ameloblastoma; dentinoid.

Figure 1

Clinical presentation of patient with swelling in upper left vestibule

Figure 2

Intra oral peri apical radiograph showing diffuse radiolucency in periapical region of canine and incisors

Figure 3

Ortho pantomogram showing diffuse radiolucency in left incisor and canine region

Figure 4

Occlusal radiograph showing diffuse radiolucency in left incisor and canine region

Figure 5

Histological picture showing H and E stained sections with odontogenic cells in plexiform arrangement and microcysts

Figure 6

H and E stained sections showing odontogenic cells arranged in whorls

Figure 7

Presence of dentinoid seen as eosinophilic stained material

Figure 8

H and E stained sections showing presence of areas with odontogenic cells arranged in ductal pattern

Figure 9

H and E stained sections showing odontogenic cells in typical plexiform ameloblastoma kind of arrangement