Abstract
A 60-year-old man presented with a unilocular radiolucent lesion of 5 months' evolution, involving tooth #48, the mandibular nerve, and extending into the mandibular ramus. Cone beam computed tomography revealed an expansive lesion with erosion of the mandible and perforation of the lingual cortical plate. The provisional diagnosis was of ameloblastoma or keratocystic odontogenic tumor. The patient underwent incisional biopsy and fine-needle aspiration cytology. Microscopic analysis showed numerous islands of odontogenic epithelium; peripheral cells arranged in a palisade, polarized nuclei; and vacuolated cytoplasm, resembling pre-ameloblasts. The central cells were loosely arranged, resembling a stellate reticulum. Based on the clinical, radiographic, and microscopic features, follicular ameloblastoma was diagnosed. The patient underwent resection of a part of the mandible and immediate reconstruction. In 3 months of follow-up, no signs of recurrence were observed. This case reinforces the importance of microscopic analysis for accurate diagnosis and management.
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