Adenoid ameloblastoma with dentinoid: A rare hybrid variant

Abstract

Odontogenic tumors comprise an unusual group of lesions of the jaw and present diverse histological patterns. Derived from the primordial tooth-forming tissues, they represent a heterogeneous group of lesions that range from hamartomas to benign and malignant neoplasms of variable aggressiveness. Sporadic case reports and diverse complex histogenetic source also defy categorization of odontogenic tumors. Many can be diagnosed accurately based on the distinctive clinical, radiological and histopathological presentation. Considerable variations in the clinicopathological presentation of odontogenic tumors can be confusing, increasing the chance of misdiagnosis. An interesting case of adenoid ameloblastoma reported in a 55-year-old male patient in the mandible, presenting with a diverse and intriguing histopathology, is discussed here.

Keywords: Adenomatoid odontogenic tumor; ameloblastoma; architecture; hamartoma; odontogenic tumor.

Figure 1

Orthopantomogram showing radiolucencies on both right and left sides of the mandible

Figure 2

Histopathological image showing cystic lumen surrounded by odontogenic epithelium with ductal or glandular pattern (H&E stain, ×100)

Figure 3

Histopathological image showing follicles lined by cuboidal and columnar cells with centrally placed stellate reticulum-like cells (H&E stain, ×200)

Figure 4

Histopathological image showing strands of epithelium lined by columnar cells and areas of spindle-shaped cells (H&E stain, ×100)

Figure 5

Histopathological image showing eosinophilic dentinoid matrix and multinucleated giant cells at the periphery (H&E stain, ×200)

Figure 6

Photomicrograph showing positive immunostaining with cytokeratin-19 (×200)