AGGRESSIVE GRANULAR CELL AMELOBLASTOMA

Abstract

Granular cell ameloblastoma (GCA) is a rare histologic variant of ameloblastoma characterized by the presence of granular cells, which have abundant cytoplasm filled with eosinophilic granules that resemble lysosomes. A 37-year-old male patient was referred to a maxillofacial surgery clinic with swelling in the mandible noticed 10 years earlier. Two previous biopsy results were suggestive of ameloblastoma. Intraorally, there was a nodular swelling in the right alveolar ridge involving the region of premolars and molars, and computed tomography showed an expansible and multilocular lytic lesion. Histologic examination revealed a lesion composed of fibrous stroma with cell sheets presenting extensive granular cell transformation, surrounded by peripheral ameloblast-like cells. Immunohistochemistry showed negativity for Ki-67. The diagnosis was GCA. A marginal resection of the mandible was performed, and the microscopic examination confirmed the diagnosis. The patient remains in monitoring, and the reconstruction surgery of the mandible will be held soon. Granular cell ameloblastoma (GCA) is a rare histologic variant of ameloblastoma characterized by the presence of granular cells, which have abundant cytoplasm filled with eosinophilic granules that resemble lysosomes. A 37-year-old male patient was referred to a maxillofacial surgery clinic with swelling in the mandible noticed 10 years earlier. Two previous biopsy results were suggestive of ameloblastoma. Intraorally, there was a nodular swelling in the right alveolar ridge involving the region of premolars and molars, and computed tomography showed an expansible and multilocular lytic lesion. Histologic examination revealed a lesion composed of fibrous stroma with cell sheets presenting extensive granular cell transformation, surrounded by peripheral ameloblast-like cells. Immunohistochemistry showed negativity for Ki-67. The diagnosis was GCA. A marginal resection of the mandible was performed, and the microscopic examination confirmed the diagnosis. The patient remains in monitoring, and the reconstruction surgery of the mandible will be held soon.