Desmoplastic Ameloblastoma of the Mandible

Pushparaja Shetty,Soniya Adyanthaya

doi:10.31729/jnma.2282

Abstract

The Desmoplastic Ameloblastoma exhibits important differences in anatomical distribution, histologic appearance and radiographic findings compared with the classic type of ameloblastoma. We describe a case of desmoplastic variant of ameloblastoma localized in the mandibular anterior portion of the jaw, extending posteriorly in the left side. The tumor was expansile, slowly growing and painless. The radiographic finding showed diffuse, radiolucent lesion with cortical bone expansion. Surgical excision was performed and follow-up examination done after two years disclosed no recurrence. The purpose of this article is to assist in better understanding of this variant of odontogenic tumor.

Highlights

Ameloblastoma is a benign epithelial odontogenic tumor that usually exhibits aggressive behavior, causes severe expansion of the cortical bones and may have a high recurrence rate.[1]
The first detailed report on the desmoplastic variant of ameloblastoma in the English literature was given by Eversole et al in 1984 who called it an ameloblastoma with pronounced desmoplasia.[5]
It has been categorized as a distinct variant of ameloblastoma in the World Health Organization (WHO) classification of odontogenic tumors in 2003 due to its distinct clinicoradiographic presentation and pathology.[8]

Summary

INTRODUCTION

Ameloblastoma is a benign epithelial odontogenic tumor that usually exhibits aggressive behavior, causes severe expansion of the cortical bones and may have a high recurrence rate.[1]. The desmoplastic variant differs from other histologic types of ameloblastoma in that it is located in the anterior or premolar regions of the maxilla or mandible It resembles a fibro-osseous lesion because of its diffuse, mixed radiolucent–radiopaque appearence with a honeycomb or soap bubble pattern and indistinct borders.[9,10] Histopathologically, desmoplastic ameloblastomas are nonencapsulated tumours with extensive collagenous stroma or desmoplasia containing small odontogenic epithelium islands and cords of various sizes.[2,11] In view of the paucity of Desmoplastic Ameloblastoma (DA) case. Histopathological examination revealed scattered odontogenic epithelial islands arranged in cords and strands showing ‘animal’ pattern in a dense fibrous connective tissue stroma (Figure 2, 3). These islands were formed of flattened peripheral cells and central polygonal or spindle-shaped cells. A clinical follow-up examination two years later disclosed no recurrence or residual tumor

DISCUSSION

Findings

CONCLUSIONS