Follicular Ameloblastoma with Granular Changes Affecting Mandible & Maxilla - A Case Report

Abstract

Ameloblastoma is defined as a benign but locally invasive neoplasm consisting of proliferating odontogenic epithelium lying in a fibrous stroma. Ameloblastomas are believed to have an epithelial origin, i.e. remnants of the dental lamina, remnants of Hertwig's root sheath (the epithelial remains of Malassez), epithelium of odontogenic cysts (particularly dentigerous cysts) and odontomas, the developing enamel organ and the basal cells of the surface epithelium of the jaws. Here we report a case of follicular cell ameloblastoma in a 45 years old female patient with a chief complaint of pain & swelling over the left side of face since 5 years. H & E stained sections showed stratified squamous hyperkeratotic epithelium with break in the continuity of the basement membrane. The underlying connective tissue contains numerous nests, strands, sheets & islands of dysplastic to atypical epithelial cells suggestive of malignancy in a fibro cellular stroma with little or no inflammatory cell infiltration. Hemimandibulectomy was done including condyle and coronoid process and the tumor mass. A 2.5 mm stainless steel reconstruction plate was fixed for the mandibular reconstruction. There was a marked resorption of the maxillary bone due to tumor expansion but maxilla was not involved directly into the tumor extension.