Case Of Unicystic Ameloblastoma Research Articles

Case of Unicystic Ameloblastoma with Features of Ameloblastic Fibro-dentinoma

Hybrid odontogenic tumours occur rarely in the oral cavity. The basic histogenesis of these lesions is not clear. Hybrid odontogenic tumours characteristically exhibit two or more distinct morphological features that may lead to a diagnostic dilemma. Unicystic Ameloblastomas (UA) are the second most common odontogenic tumour. Ameloblastic Fibro-dentinoma (AFD) is a rare mixed odontogenic tumour. Both UA and AFD commonly occur in the second decade of life, may be asymptomatic with a slight female predilection, and predominantly occur in the mandibular posterior region. Herein, the authors report a rare case of a 15-year-old female patient complaining of swelling in the right lower posterior jaw region in the last two months. The lesion was surgically enucleated and sent for histopathological examination. On histopathological examination, the lesion exhibits areas of both UA and AFD, representing a rare occurrence of a hybrid odontogenic tumour. The present case report highlights the unique combination of two odontogenic tumours of different origins

Case of unicystic ameloblastoma with review of literature

AbstractIntroductionAmeloblastoma is one of the most frequent benign odontogenic tumours of the jaw, accounting for approximately 10% of all tumours in the mandible and maxilla. It is a slow‐growing, locally invasive tumour that causes painless swelling of the jaw or maxilla.DiagnosisAmeloblastoma is diagnosed through computerised tomography imaging and a biopsy. A biopsy can help distinguish ameloblastoma from other cancers, such as ossifying fibroma, osteomyelitis, giant cell tumour, cystic fibrous dysplasia, myeloma, and sarcoma.TreatmentAmeloblastoma is best treated with vigorous en bloc excision and concomitant repair. Ameloblastoma therapy has long been plagued by high recurrence rates and extensive tissue abnormalities. Recent molecular findings strongly imply that ameloblastoma patients may benefit from targeted treatment. We offer a case report of unicystic ameloblastoma with a step‐by‐step customised therapeutic plan that prioritises patients’ desire.

Myofibroblasts in Odontogenic Cysts and Tumors: An Immunohistochemical Study.

The objective of this study was to assess immunohistochemically the presence of myofibroblasts both qualitatively and quantitatively in odontogenic cysts and tumors and to compare with the control cases of squamous cell carcinoma and to correlate the results with biologic behavior of these lesions. Formalin-fixed, paraffin-embedded blocks of odontogenic cysts and tumors were retrieved from institutional archives. The sample size is 40; these include ten cases of odontogenic keratocyst (OKC) (n = 10), five cases of dentigerous cyst (n = 5), ten cases of solid ameloblastoma (n = 10), and five cases of unicystic ameloblastoma (n = 5). Ten cases of squamous cell carcinoma (n = 10) served as control. Sections were taken and stained immunohistochemically using alpha-smooth muscle actin for evaluation of myofibroblasts. The number of positive stromal cells was evaluated both for quantitative and qualitative analyses. The present study showed that the mean number of myofibroblasts among the odontogenic cysts and tumors was higher in locally aggressive lesions such as OKC (23.79 ± 19.95), solid ameloblastoma (26.38 ± 17.00), and unicystic ameloblastoma (20.74 ± 14.86) which were comparable to squamous cell carcinoma (21.49 ± 9.76) when compared to benign lesions like dentigerous cyst which showed the least number of myofibroblasts (13.1 ± 7.71). Qualitatively, the staining intensity of myofibroblasts showed a significant variation within the same lesion and among different lesions. There was a distinct difference in the morphology, pattern of arrangement, and distribution of myofibroblasts among the studied lesions. We conclude that the increase in the number of myofibroblasts could be one of the contributory factors for the locally aggressive behavior of benign lesions such as ameloblastomas and OKCs. Further studies are suggested to understand the mechanism by which these important cellular elements exert their effects on stromal and epithelial tissue compartments.

Immunohistochemical Expression of MMP-9 and E-Cadherin in subtypes of Ameloblastoma.

ABSTRACTBackground & Objective:Ameloblastomas have been analyzed histologically for diagnostics and its sub-classification; however, the analysis carried out so far does not provide any authentic evidence regarding prognosis of Ameloblastoma. Subject categorization is still a topic of debate. The purpose of this study was to determine the immuno-expression of markers such as MMP-9 and E-Cadherin in different sub-types of ameloblastoma and establish their correlation with histological variants.Methods:Analytical study of 71 cases of ameloblastoma was conducted in AFIP Rawalpindi, between January to June, 2019. Samples were taken from different intraoral sites including the patients with tumor of ameloblast. The tumor was sub classified histologically on the basis of WHO classification. ‘Chi Square’ Test was applied to find the association of MMP-9 and E-Cadherin with histological variants of ameloblastoma. P-value ≤ 0.05 were found statistically significant.Results:On histopathological sub-classification, 52.1% were diagnosed as follicular type, 23.9% were plexiform type, 14.1% were Acanthomatous type and 9.9% were of unicystic ameloblastoma. 80% of the total Acanthomatous type and 59% of the total plexiform had strong immuno-expression, which was significantly different from follicular type MMP-9 (p ≤ 0.05). All cases of unicystic ameloblastoma and 67.6% of follicular type showed strong immuno-expression significantly different from 20% of Acanthomatous type and 59% of plexiform type E-Cadherin (p ≥ 0.05). On the other hand, when statistical analysis was carried out, an inverse relation between MMP-9 and E-cadherin was observed.Conclusion:The effect of MMP-9 and E-cadherin in ameloblastoma is aggressive in nature and effectiveness was seen in subtypes of ameloblastoma.

Modified conservative management of mandibular ameloblastoma: a 13‐year experience in a Malaysian tertiary care centre

AbstractPurposeAlthough surgical resection is routinely used to treat mandibular ameloblastoma, it associates with aesthetic and functional complications, hence a modified conservative management (MCM) comprising surgical enucleation, peripheral ostectomy and chemical cauterisation was practiced in a tertiary care centre in northern Malaysia. This study aims to access the treatment outcome and potential use of MCM.MethodsThis cross‐sectional study assessed the demographic and clinical profiles of mandibular ameloblastomas managed with MCM and their outcomes from year 2006 to 2019.ResultsA total of 13 cases of mandibular ameloblastoma were identified between 2006 and 2019 with MCM, which consisted of nine cases of solid/ multicystic ameloblastoma (SMA) (84.6%), and two cases of unicystic ameloblastoma (UA). Over mean review duration of 57 month, three recurrences (23.2%) were reported for SMA group and no recurrence was found for UA cases.ConclusionsThe relatively low recurrence rates suggest that MCM has potential to be used as an alternative treatment for mandibular ameloblastoma. Further well‐designed prospective study is recommended to understand the effectiveness of MCM, which hopefully can evolve towards a minimally invasive surgical approach in treating mandibular ameloblastoma.

Calretinin Expression in Unicystic Ameloblastoma and Odontogenic Cysts

Background: Unicystic ameloblastoma arises from similar tissues as the odontogenic cysts. It may also arise from the epithelial lining of these cysts. Furthermore, the epithelial lining of unicystic ameloblastoma is variable and may be almost completely nondescript, which may lead to diagnostic confusion with odontogenic cysts. Calretinin is a calcium-binding protein that has been suggested to be a specific immunohistochemical marker for ameloblastic tissues. The aim of this study was to investigate the usefulness of calretinin in the differentiating unicystic ameloblastoma from odontogenic keratocyst, dentigerous cyst and radicular cyst of the jaws. Materials and Methods: Formalin-fixed, paraffin embedded tissue blocks of 23 unicystic ameloblastomas, 6 odontogenic keratocysts, 8 dentigerous cysts and 10 radicular cysts were utilized. Five micrometer thick sections were made from the tissue blocks and mounted on silanized glass slides. Immunohistochemical staining was done using a 1:100 dilution of mouse monoclonal anti-calretinin primary antibodies (Abcam, SA; Clone 1F5H1) and incubating overnight at 4°C. The staining reaction was visualised using diaminobenzidine substrate solution. Stained tissue sections were evaluated for the presence, distribution, and intensity of staining of the immunoreactive cells. Data analysis was done using SPSS version 23. Statistical tests employed were Chi square test and Kruskal-Wallis test. The level of significance was set at 95% (p-value < 0.05). Results: Calretinin expression was seen in 14 (60.9%) cases of unicystic ameloblastoma, 3 (50.0%) cases of odontogenic keratocyst and a lone (12.5%) case of dentigerous cyst. None of the 10 cases of radicular cyst showed positive expression of calretinin. Staining in unicystic ameloblastoma was mostly localized to the superficial layers, whereas in odontogenic keratocyst it involved all layers of the epithelial lining. There was significant association between lesion type and the immunohistochemical expression of calretinin (p = 0.003). There were also significant differences in calretinin immunoreactivity of unicystic ameloblastoma compared to dentigerous cyst and radicular cyst. Conclusion: The findings of this study suggest that calretinin expression could help differentiate unicystic ameloblastoma from dentigerous cyst and radicular cyst, but not from odontogenic keratocyst.

Relative frequencies of odontogenic cysts and their protein and glucose content

&#x0D; Background: Odontogenic cysts are derived from remnants of odontogenic apparatus entrapped within jawbones. The diagnosis of cysts is based on histology features; however, these features are not clear-cut in many cases, except for a few like OKC and Calcifying Odontogenic cyst. The knowledge of the content of these cysts may assist in the differentiation and diagnosis of the cysts. This study reviewed the pattern of jaw cysts presentation and further analyzed the glucose and protein contents of some odontogenic cysts among them. The findings from our local environment were compared with findings globally as regards jaw cysts.&#x0D; Methods: Aretrospective search of the departmental records of Oral and Maxillofacial Surgery and Oral Pathology of the University College Hospital Ibadan was done from the year 2010 to 2017 for jaw cysts. The cystic content of odontogenic cysts was analyzed prospectively from 2016 to 2017 for total protein, albumin and glucose. Some cases of unicystic ameloblastoma were included because as at the time of obtaining the aspirate the working diagnosis was jaw cyst. Total protein, albumin and glucose estimations of the cysts were done by Biuret, Bromocresol Green and Glucose Oxidase methods respectively. The literature search was done on PubMed, using the keywords cysts, jaw cysts, odontogenic cysts, protein, albumin, glucose content.&#x0D; Results: 1,156 lesions were diagnosed within the study period of 7 years, among which 45 lesions (3.9%) were jaw cysts of odontogenic origin. Collectively the mean age at presentation was 30.8 (SD ± 17.2) years while it was 32.7 (SD±14.4), 21.6 (SD±14.6) and 40.1 (SD±24.0) years for radicular cyst, dentigerous cyst and OKC respectively. The mean concentration of total protein was highest in radicular cysts (6.2g/dL) compared with the dentigerous cysts.&#x0D; Conclusion: Radicular cyst is the most common odontogenic cyst followed by the dentigerous cyst. The radicular cyst favours the anterior maxilla while the dentigerous cyst favours the posterior mandible. Caution should be exercised when interpreting the results of protein estimation of odontogenic cystic fluids.&#x0D; &#x0D;

Relative Frequencies of Odontogenic Cysts and their Protein and Glucose Content

Background: Odontogenic cysts are derived from remnants of odontogenic apparatus entrapped within jawbones. The diagnosis of cysts is based on histology features; however, these features are not clear-cut in many cases, except for a few like OKC and Calcifying Odontogenic cyst. The knowledge of the content of these cysts may assist in the differentiation and diagnosis of the cysts. This study reviewed the pattern of jaw cysts presentation and further analyzed the glucose and protein contents of some odontogenic cysts among them. The findings from our local environment were compared with findings globally as regards jaw cysts.&#x0D; Methods: Aretrospective search of the departmental records of Oral and Maxillofacial Surgery and Oral Pathology of the University College Hospital Ibadan was done from the year 2010 to 2017 for jaw cysts. The cystic content of odontogenic cysts was analyzed prospectively from 2016 to 2017 for total protein, albumin and glucose. Some cases of unicystic ameloblastoma were included because as at the time of obtaining the aspirate the working diagnosis was jaw cyst. Total protein, albumin and glucose estimations of the cysts were done by Biuret, Bromocresol Green and Glucose Oxidase methods respectively. The literature search was done on PubMed, using the keywords cysts, jaw cysts, odontogenic cysts, protein, albumin, glucose content.&#x0D; Results: 1,156 lesions were diagnosed within the study period of 7 years, among which 45 lesions (3.9%) were jaw cysts of odontogenic origin. Collectively the mean age at presentation was 30.8 (SD± 17.2) years while it was 32.7 (SD±14.4), 21.6 (SD±14.6) and 40.1 (SD±24.0) years for radicular cyst, dentigerous cyst and OKC respectively. The mean concentration of total protein was highest in radicular cysts (6.2g/dL) compared with the dentigerous cysts.&#x0D; Conclusion: Radicular cyst is the most common odontogenic cyst followed by the dentigerous cyst. The radicular cyst favours the anterior maxilla while the dentigerous cyst favours the posterior mandible. Caution should be exercised when interpreting the results of protein estimation of odontogenic cystic fluids.

Cell proliferation proteins and aggressiveness of histological variants of ameloblastoma and keratocystic odontogenic tumor

ABSTRACTTumors that originate from the epithelium of the odontogenic apparatus are classified as benign or malignant. The proliferative activity could provide a basis for differences in the biologic behavior among the histological variants of ameloblastoma (AM) and keratocystic odontogenic tumor (KCOT). We examined 32 solid AM and 18 KCOT cases. The AM sample comprised 16 cases of follicular AM, six cases of unicystic AM, eight cases of plexiform AM and two cases of acanthomatous AM. Sections were stained with the Ki-67 antibody. Ten representative fields were selected randomly in each section. For AM, peripheral tall columnar cells of tumor islands/nests/cords were selected. For KCOT, fields were selected in the basal and the suprabasal region of the epithelial lining. We counted the average number of Ki-67 positive cells/field for AM and KCOT. AM exhibited Ki-67 expression in peripheral tall columnar cells, whereas KCOT exhibited Ki-67 expression in the basal and suprabasal layer. No significant difference between AM and KCOT was observed; the cellular proliferative activity varied among the subtypes. No significant difference in Ki-67 expression in acanthomatous, cystic and follicular types of AM was observed, although the plexiform type exhibited significantly higher levels than the other three types. High expression of Ki-67 could be a useful prognostic marker for proliferative activity and a prognostic indicator for recurrence rate of AM and KCOT.

Histomorphological Evidence of Cellular Cannibalism in Ameloblastoma

To study the cellular cannibalism (CC) in the tumor cells of ameloblastoma. Hematoxylin and eosin (HE)-stained sections of ameloblastoma cases (50) were retrieved from the archived specimens and screened for cellular cannibalism (CC) by stellate reticulum-like cells. Further characterization of CC was performed using CD68 and lysozyme antibodies. CC was observed in 15 (30%) cases [follicular 10 (66.66%), unicystic 3 (20%), and acanthomatous 2 (13.33%)]. In acanthomatous ameloblastoma, the CC was observed in the central metaplastic squamous cells, while in 3 cases of unicystic ameloblastoma, CC was seen in stellate reticulum-like cells of intraluminal (2) and mural proliferations (1). All the 15 cases of ameloblastoma showed a negative expression of CD68 as well as lysozyme. CC is a new addition to the pathogenesis of ameloblastoma.

Conservative management (marsupialization) of unicystic ameloblastoma: literature review and a case report

BackgroundIn this study, we present a case of unicystic ameloblastoma (UA) treated by marsupialization followed by surgical enucleation as a conservative approach. UA is a rare, benign, less aggressive, and less invasive variant of ameloblastoma that is observed quite often in younger patients. Radical approaches have effects on the physical and psychological development of a growing young patient; therefore, conservative approaches are widely used for UA management in children.Case presentationThis report described a case of an 11-year-old girl with UA of the mandibular molar–ramus area, which also involved impaction of the second and third molars. The lesion was marsupialized, and 31 months after marsupialization, surgical enucleation was performed with extraction of the impacted third molar. The second molar, which was preserved, spontaneously and completely erupted. No recurrence was observed during a 49-month follow-up.ConclusionsConservative treatments for UA in young patients have more advantages. Our results provide evidence that marsupialization is effective in regressing the lesion size to ease complete removal, preserving mandibular growth, maintaining involved second molar, and promoting the eruption of the tooth.

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.

COMPARATIVE STUDY OF CALRETININ EXPRESSION IN ODONTOGENIC CYSTS AND TUMORS

Calretinin is a calcium-binding protein with molecular weight of 29 kDa (KiloDalton). It is expressed in a variety of normal and tumorigenic tissues. Its expression in odontogenic epithelium during odontogenesis and in neoplastic odontogenic tissues has been demonstrated. This study was undertaken to evaluate the expression of Calretinin in a group of odontogenic cysts and tumors. The expression of Calretinin was evaluated immunohistochemically in 42 samples including 8 cases of periapical cyst, 7 cases of dentigerous cyst, 7 cases of keratocystic odontogenic tumor, 8 cases of solid (multicystic) ameloblastoma, 6 cases of unicystic ameloblastoma and 6 cases of adenomatoid odontogenic tumor. Positive immunohistochemical reaction was found in all cases of solid ameloblastoma (100%), in 4 cases of unicystic ameloblastoma (67%) and 4 cases of keratocystic odontogenic tumors (57%) whereas none of the other odontogenic cysts and adenomatoid odontogenic tumors included in this study showed reactivity. Intensity was higher in the ameloblastomas compared with the keratocystic odontogenic tumors. On the basis of these results, it is suggested that calretinin might be used as a specific immunohistochemical marker for the ameloblastomas and could play an important role in the differentiation of aggressiveness of different odontogenic tumors.

Glypican-3 distinguishes aggressive from non-aggressive odontogenic tumors: a preliminary study.

Glypican-3 is a cell surface proteoglycan that is found in embrionary tissues, and there are no studies investigating this protein in odontogenic tumor. Thus, the aim of this study was to investigate glypican-3 in a series of aggressive and non-aggressive odontogenic tumors. Fifty-nine cases of tumors were divided into aggressive odontogenic tumors (20 solid ameloblastomas, four unicystic ameloblastoma, 28 KOTs including five associated with Gorlin-Goltz syndrome) and non-aggressive odontogenic tumors (five adenomatoid odontogenic tumors and two calcifying cystic odontogenic tumors) and analyzed for glypican-3 using immunohistochemistry. Glypican-3 was observed in seven solid ameloblastoma and eighteen keratocystic odontogenic tumors including three of the five syndromic cases, but there was no significant difference between syndromic and sporadic cases (P > 0.05; Fisher's exact Test). All cases of unicystic ameloblastoma (n = 4), adenomatoid odontogenic tumor (n = 5), and calcifying cystic odontogenic tumor (n = 2) were negative. This provided insights into the presence of glypican-3 in odontogenic tumors. This protein distinguished aggressive from non-aggressive odontogenic tumors.

Immunohistochemical expression of matrix metalloproteinases in ameloblastomas and pericoronal follicles.

Ameloblastoma (AM) is a benign odontogenic neoplasm characterized by local invasiveness and recurrence. We compared the immunohistochemical expression of matrix metalloproteinases in different clinical types of AM as well as in normal odontogenic tissue. Thirteen cases of solid AMs, five cases of unicystic AM and eight pericoronal follicles (PF) were selected and subjected to immunohistochemical investigation for matrix metalloproteinase-1, matrix metalloproteinase-2 and matrix metalloproteinase-9 expressions. The expressions of MMP-1 and MMP-2 were very high in the cytoplasm of cells throughout the entire epithelium and in fibroblasts from the adjacent connective tissue. MMP-9 expression was observed in the same location although with weaker staining. The Kruskal-Wallis test showed statistically significant differences in the epithelial expressions of MMP-1 and MMP-2; there was lower expression among solid AMs when compared with unicystic AM and PF. Compared to both types of AM, higher stromal expression of MMP-9 was found in PF. MMP-1, MMP-2 and MMP-9 seem to be associated with AM tumour behaviour as well as physiological tissue remodelling within PF.

Non dentigerous variant of unicystic ameloblastoma: A case report

Unicystic ameloblastoma is one of the placid jaw tumors comprising about 6-15% of ameloblastoma, it stands unexampled when it comes to the pathomorphological features. We discuss a case of unicystic ameloblastoma that is consonant with the nondentigerous multilocular unicystic ameloblastoma. The case was initially misdiagnosed as ameloblastic fibroma in a private diagnostic centre. Upon examining the resected specimen, we derived at the diagnosis of unicystic ameloblastoma, 1.2.3 type. The age of our case is also akin to the previous literature.

Unicystic Ameloblastoma Presenting in Gardner’s Syndrome

Sir, a 15-year old female patient was recently referred to the Department of Oral and Maxillofacial Surgery, Sunderland Royal Hospital, for investigation of an unerupted 31 (using the Universal Numbering System; 47 using FDI notation). The patient had recently been diagnosed with Gardner’s syndrome. A DPT radiograph revealed a well-defined, unilocular radiolucency centred on the crown of an unerupted 31. Tooth 31 was displaced towards the lower border of the mandible (Fig. 1a). A posterior-anterior (PA) jaws radiograph showed minimal bucco-lingual expansion (Fig. 1b). The clinical and radiological features were consistent with a dentigerous cyst. The cyst was enucleated and the 31 surgically removed under general anaesthetic. Histopathological examination demonstrated a unilocular fibrous walled cyst lined by cuboidal and columnar epithelium. In places, the basal epithelial cells were palisaded and showed reversed nuclear polarity, similar to ameloblasts (Fig. 2). The epithelial cells showed strong expression of CD56 by immunohistochemistry, suggesting pre-ameloblastic differentiation [1]. The features were consistent with sampling of an ameloblastoma. The young age of the patient, the distinct clinical presentation (mimicking a dentigerous cyst) and the surgical removal of a simple cyst were consistent with unicystic ameloblastoma. We were interested to read a case report by Patel and Rees [2] that documented an association between unicystic ameloblastoma and Gardner’s syndrome. At the time, the authors conceded that the occurrence of the two conditions may have been coincidental. Gardner’s syndrome has a well-recognised association with dental anomalies, such as odontomes and unerupted teeth, which account for an increased incidence of dentigerous cysts in these patients [3]. The histopathological differences between dentigerous cyst and unicystic ameloblastoma can be subtle and supervening infection and inflammation can also hamper accurate diagnosis. It is therefore conceivable that unicystic ameloblastoma is under-diagnosed in Gardner’s syndrome. Furthermore, unicystic ameloblastoma is usually adequately treated by enucleation, similar to a dentigerous cyst; consequently, cases are unlikely to be revisited by the clinicians or the pathologist. This raises the possibility that there are other, as yet undocumented, cases of unicystic ameloblastoma in Gardner’s syndrome. We would be interested to know whether other readers have encountered this association. Fig. 1 a DPT showing the unerupted 31 and associated unilocular radiolucent lesion. b PA jaws shows minimal bucco-lingual expansion around the 31 Fig. 2 Haematoxylin and eosin section through the surgical specimen (×100 original magnification)

Unicystic ameloblastoma in an infant: A management dilemma

The authors describe the conservative management of a rare case of unicystic ameloblastoma (mural subtype) in a 10-month-old girl, the youngest patient reported thus far in the literature. Rather than subject the infant to further surgery, it was decided to monitor her closely and perform an additional operation in the event of recurrence, thus enabling uninterrupted mandibular growth and tooth development. The patient is now 3.5 years old and periodic follow-up is ongoing, with no evidence of recurrence.

Diagnosis and management of unicystic ameloblastomous lesion of the mandible. Does it influence the clinician- A report of a case and differential diagnosis

Ameloblastomas are an enigmatic group of tumours. Their name implies a resemblance to cells of enamel forming organ (dental hard tissues). Ameloblastoma is an odontogenic tumour which is an archetype of a neoplasm where the neoplastic component is epithelial only without contribution from the ectomesenchyme. Most common odontogenic neoplasm in Indian population. Ameloblastoma is locally aggressive, but often asymptomatic, showing a slow growth which is manifested as a facial swelling or radiographic incidental finding. Unicystic ameloblastoma refers to those cystic lesions that show clinical, radiographic, or gross features of a mandibular cyst, but on histological examination show a typical ameloblastomatous epithelium lining with or without luminal tumour growth. We present an unusual case of unicystic ameloblastoma appearing as an interdental radiolucent lesion of the mandible in a 26 years old male patient. In addition, an insight on the various pathologies such as radicular cyst, lateral periodontal cyst, collateral keratocystic odontogenic tumour, Squamous odontogenic tumour, central giant cell granuloma, extra follicular adenomatoid odontogenic tumour, central odontogenic myxoma, glandular odontogenic cyst, calcifying epithelial odontogenic tumour, with similar presentations were critically evaluated & discussed in differential diagnosis of such entities.

UNI CYSTIC AMELOBLASTOMA: CLINICALLY A MISSED DIAGNOSTIC ENTITY- 3 CASE REPORTS

Unicystic ameloblastoma a variant of solid or multicystic ameloblastoma mimicking clinically, radiographically, and grossly with jaw cysts, but histopathologically demonstrates a typical ameloblatomatous (odontogenic) epithelial lining with or with out luminal and lor mural growth. Unicystic ameloblastoma tend to occur in younger age group with preferred site of occurrence in the posterior mandible with favorable biological behavior. This report presents 3 cases of unicystic ameloblastoma in different age group with varied clinical and radiographic features which directed to misdiagnose the lesion clinically. But histopathology rooted to confirm the diagnosis.