Cases Of Desmoplastic Ameloblastoma Research Articles

Desmoplastic Ameloblastoma with Prominent Osteoplasia (Osteoplastic Ameloblastoma) as a Recurrence after 14 Years: A Case Report and Literature Review

Background: Ameloblastoma is the most common odontogenic tumor arising from the odontogenic epithelium and is known for its distinct aggressive clinical behaviour and characteristic histologic picture. Very few cases of desmoplastic ameloblastoma with prominent osteoplasia (osteoplastic ameloblastoma) exhibiting formation of metaplastic bone trabeculae rimmed by active osteoblasts have been described. Case Presentation: We report an interesting case of desmoplastic ameloblastoma with prominent osteoplasia (osteoplastic ameloblastoma) in a 38-year-old male presented as a recurrence after 14 years in the anterior mandible. Conclusion: A hybrid lesion of desmoplastic ameloblastoma with osteoplastic pattern (osteoplastic ameloblastoma) needs inclusion of new cases to understand their behaviour. Recurrence of lesion after 14 years of initial surgery in our case presents the importance of regular bi-annual follow-up for lifetime.

Immunohistochemical Expression of Myofibroblasts Using Alpha-smooth Muscle Actin (SMA) to Assess the Aggressive Potential of Various Clinical Subtypes of Ameloblastoma.

Objective:Ameloblastoma is a rare odontogenic neoplasm with high recurrence rates if improperly treated. If left untreated (or is treated inadequately), it can cause substantial morbidity, disfigurement, and even death. Hence, there is a need to explore the stromal cells too, which might play an important role in assessing its aggressive behavior and may help to predict the recurrence of different clinical variants of ameloblastoma. Myofibroblasts (MFs) are such cells which have been studied in various lesions.Materials and Methods:This retrospective study involved archival tissues of ameloblastoma. Among a total of 40 cases, 12 cases of SMA (solid multicystic ameloblastoma), 10 cases of unicystic ameloblastoma (UA), 8 cases of desmoplastic ameloblastoma, and 10 cases of oral squamous cell carcinoma were selected as control. Immunohistochemical staining with anti-alpha-smooth muscle actin antibody was done. Interpretation of ten examined fields was counted by three observers.Results:Significant difference in the number of MFs in SMA and UA and desmoplastic ameloblastoma and UA (P < 0.05) was found. However, there was no statistically significant difference in MFs of SMA and desmoplastic ameloblastomas (P > 0.05). In addition, there was no statistically significant difference in the staining intensity between the three variants (P > 0.05).Conclusion:A significant correlation was obtained between the number of MF in all the three clinical variants, i.e., SMA, UA, and desmoplastic ameloblastoma (P = 0.02), which is the unique feature of the study.

Podoplanin Protein Expression in Some Benign and Malignant Variants of Ameloblastoma (An immunohistochemical study)

Aim: The aim of this study was to evaluate immunohistochemical expression of podoplanin among some benign and malignant variants of ameloblastoma. Material and methods: Thirty seven benign ameloblastoma (AB) tumors werecollected, (six cases of follicular AB, three cases of acanthomatous AB, four cases of granular AB, three cases of basal cell AB and seven cases of plexiform pattern AB), three cases of desmoplastic AB, four cases of peripheral AB and seven cases of unicystic AB (three cases of luminal, two cases of intraluminal and two cases of mural) and eighteen malignant variants of ameloblastoma tumors were collected as paraffin embedded blocks. Immunohistochemical investigation using podoplanin antibody was done for all specimens. Results: The mean area percent of immunoexpression was greatest inmalignant variants of ameloblastoma, followed by benign variants of ameloblastoma tumors and the least value recorded in acanthomatous ameloblastoma. The mean area percent of immunoexpression was greater in plexiform ameloblastoma in comparison to follicular ameloblastoma. The mean area percent of immunoexpression was greatest in ameloblastic carcinoma. Conclusions: Podoplanin is associated with the malignant transformation risk and is a potent biomarker for risk assessment in oral malignant transformation.

Desmoplastic ameloblastoma: a report of two clinical cases

Desmoplastic ameloblastoma is a relatively rare histological variant of ameloblastoma with specific clinical, radiological, and histological features. Although radiographic examination of ameloblastomas usually reveals unilocular or multilocular radiolucency, desmoplastic ameloblastoma may appear as a mixed radiopaque-radiolucent lesion resembling benign fibro-osseous lesions. Histologically, desmoplastic ameloblastoma is characterized by small nests and strands of compressed odontogenic epithelium supported by pronounced collagenized stroma. This report describes two cases of desmoplastic ameloblastoma in the anterior maxilla of a female patient and the anterior mandible of a male patient, mimicking clinically as an odontogenic cyst.

Ｄｅｓｍｏｐｌａｓｔｉｃ ａｍｅｌｏｂｌａｓｔｏｍａに関する臨床的，Ｘ線学的ならびに病理学的検討

Some ameloblastomas consist of sparse small nests and strands of odontogenic epithelium associated with desmoplastic stroma. This type of ameloblastoma was designated as desmoplastic ameloblastoma in the new WHO classification of odontogenic tumors in 1992. Over the past 22 years from 1970 to 1991, we diagnosed 4 cases of desmoplastic ameloblastoma among 124 primary cases of ameloblastoma, and analyzed them clinically, radiologically and histopathologically.1. The age at the initial visit was the third decade or over. Three cases occurred in the mandible and one case in the maxilla. The incidence of desmoplastic ameloblastoma was 3.2% of all ameloblastomas in the jaw bones.2. Three cases occurred in the anterior to the first premolar region and one case in the anterior to the first molar. These tumors seemed to develop from the alveolar process.3. Radiologically, all cases showed a honeycomb appearance containing mottled or dotted radiopacities with ill-defined margins.4. Divergency of tooth roots was seen in all cases, and some roots showed prominent resorption.5. Grossly, all tumors were solid type. Histologically, small sparse nests which showed acanthomatous type, stroma containing abundant collagen fibers, and many irregularly shaped areas of lamenar bone were observed. In the irregular bone, bone resorption and formation was seen concomitantly. The tumor invaded the adjacent bone marrow.6. Marginal resection was performed in 3 cases and enucleation followed by curettage in one case. No recurrence was noted.

The desmo-and osteoplastic ameloblastoma: Histologic variant or clinicopathologic entity? Case reports

Two cases of desmoplastic ameloblastoma (DA) are presented, bringing the total number of reported cases to 29. One case of the so-called “hybrid lesion” is added to the presentation. Immunohistochemical studies indicate that the desmoplasia is caused by active de nova synthesis of extracellular matrix proteins. Moreover, the DA may also show osteoplasia, and this probably explains the characteristic radiographic appearance of many DAs, i.e. the occurrence of both radiolucent and radiopaque changes, suggestive of a fibro-osseous lesion. Many more cases of DA are needed to clarify the true nature of this most interesting tumor.