Desmoplastic Ameloblastoma Research Articles

SURGICAL MANAGEMENT OF DESMOPLASTIC AMELOBLASTOMA: CONSERVATIVE OR RADICAL APPROACH

Ameloblastoma is a benign odontogenic tumor of epithelial origin. It is locally aggressive with unlimited growth capacity and a high potential for malignant transformation and metastasis. (1) Nowadays, there are two opposing approaches to the surgical management of ameloblastoma. The conservative approach consists of enucleation and/or curettage and the radical approach consists of bone resection with margins of at least 1cm (segmental or not). (2) In this work, we will present a case of desmoplastic ameloblastoma diagnosed in 2014. The patient had been benefiting from regular follow-up. However, a recurrence occurred in 2021. This paper delves into our experiences in managing desmoplastic ameloblastoma, initially employing a conservative approach in 2014 and later transitioning to a radical approach in 2021 in response to the recurrence.

Desmoplastic histological subtype of ameloblastoma in 16 dogs.

Ameloblastoma in dogs most often has a highly conserved acanthomatous cell morphology and is recognized as canine acanthomatous ameloblastoma (CAA) while conventional ameloblastoma (CA) makes up a smaller yet morphologically diverse group of epithelial odontogenic tumors. In humans, a rare desmoplastic histological subtype has distinctive clinical, radiological, and microscopic features. Desmoplastic ameloblastoma (DA) has not previously been described in dogs, although it has been rarely referenced in the veterinary literature. This is the first thorough description of a case series of DA in dogs and describes clinical presentation, diagnostic imaging findings, histopathological features for diagnosis, and treatment outcome. Clinically, DA most often presents as a mass or swelling in the rostral mandible or maxilla of middle age to older dogs. On diagnostic imaging, the lesion has a radiolucent or mixed pattern with well-defined borders and variable loculation. As a solid, fibrous tumor with obscured odontogenic epithelium, DA is challenging to diagnose histologically and can mimic several other oral tumors, both benign and malignant. As an ameloblastoma, the biological behavior of DA is locally destructive yet benign and prognosis is favorable following surgical excision.

A Rare Variant of Ameloblastoma of the Oral Cavity: A Review and Case Report

Abstract Ameloblastoma is a very rare odontogenic tumor of the oral cavity, with different histologic variants. One of the types of ameloblastoma is desmoplastic ameloblastoma (DA) which has 4%–5% of incidence. Here, we review and reported the DA is the least of occurrence of all the variants of ameloblastoma. The uniqueness of this lesion can be further enlightened with respect to its site of occurrence, the radiographic feature and the histological appearance different from the classical type of ameloblastoma. This case report focuses on a DA that occurred in the maxilla of a 35-year-old woman and explains about clinical, radiographic findings, histopathologic findings, and treatment plan. The patient is undergoing routine follow-up and is presently free of disease. From this case, the clinicians should remember to consider the DA as differential diagnosis, if a patient complaints of swelling in and around the premolar region of maxilla.

Comment on "'Collision Tumour' Involving Desmoplastic Ameloblastoma and Squamous Odontogenic Tumour: Diagnostic Precision and Implications" - A Need for Reevaluation of Histopathological Findings.

Comment on "'Collision Tumour' Involving Desmoplastic Ameloblastoma and Squamous Odontogenic Tumour: Diagnostic Precision and Implications" - A Need for Reevaluation of Histopathological Findings.

Collision Tumour Comprising Desmoplastic Ameloblastoma and Squamous Odontogenic Tumour in the Anterior Maxilla: A Case Report.

Collision tumours, characterized by the simultaneous occurrence of two distinct neoplasms within the same anatomical site, are exceedingly rare in oral pathology. This case report presents an uncommon collision tumour involving desmoplastic ameloblastoma and squamous odontogenic tumour in the anterior maxilla of a 52-year-old male from the Indian population. Desmoplastic ameloblastoma is a variant of ameloblastoma known for its unique histopathological features, while squamous odontogenic tumour is a benign epithelial odontogenic tumour with distinctive clinical behaviour. The rarity of this occurrence emphasizes the need for accurate diagnosis and effective treatment strategies. This report discusses the clinical presentation, radiographic findings, and histopathological characteristics of this collision tumour. Through the presentation of this case, we aim to contribute to the understanding of these rare entities and their management considerations.

GRANULAR CELL AMELOBLASTOMA OF MANDIBLE: REVIEW OF A RARE VARIANT OF AMELOBLASTOMA WITH PRESENTATION OF 3 INTERESTING CASES OF THE SAME.

Ameloblastoma is a benign odontogenic neoplasm derived from odontogenic epithelium with mature brous stroma without ectomesenchyme. Based on its clinical,radiographic and histological features,it has been mainly classied under four different typessolid/multicystic,unicystic,peripheral and desmoplastic ameloblastoma. The granular cell ameloblasatoma,a rare histological variant mainly seen in association with plexiform or follicular ameloblastoma of the solid/multicystic type, has been reported in 5% of the cases. The aim of this paper is to present a series of 3 interesting cases of granular cell ameloblastoma with a detailed review on clinical and histopathological features of the same.

Desmoplastic ameloblastoma of maxilla - A case report

Desmoplastic ameloblastoma is an unusual type of ameloblastoma which varies substantially from other variants of ameloblastoma. This case report describes a case of desmoplastic ameloblastoma in a 40-year-old male patient who presented with a swelling in the right maxillary anterior region which was painless in nature. The patient was apprehensive about the asymmetry caused by the massive tumor. Initially, conventional computed tomography was done, and the diagnosis was confirmed by histopathology. Surgical resection of the tumor was done, and a prefabricated prosthetic splint was given postoperatively. The surgical site healed completely, and there was no recurrence at 6-month follow up. The present case report emphasizes the specific histological features of the tumor. Due to its invasive nature, early intervention is needed to reduce the disfigurement, functional hindrance, and other complications caused by the tumor.

Desmoplastic Ameloblastoma: A Case-Series of Three Cases

The desmoplastic ameloblastoma is an uncommon subtype of ameloblastoma. Clinical and radiographic presentation differs from other forms of ameloblastoma, and the lesion is sometimes confused with fibro-osseous lesions, making it important for clinicians to review its distinctive clinical and radiographic features. The authors in this article present three cases of desmoplastic ameloblastomas, which were treated at the Augusta University Oral and Maxillofacial Surgery clinic.

Airway Management: A Case of Desmoplastic Ameloblastoma of Right Mandibular Body

Background- Desmoplastic ameloblastoma (DA) is an uncommon variety of ameloblastoma that accounts for 4–13% of all cases, with notable differences in anatomical location, imaging, and histologic appearance. It is classified as a variety of ameloblastoma in the WHO classification of head and neck tumours (WHO-2005). Because it commonly occurs in the anterior region of the jaws as a mixed radio-opaque-radiolucent lesion, the tumour resembles a benign fibro-osseous lesion.
 Case report- We present a case of desmoplastic ameloblastoma in a 51-year-old female with a painless swelling in the lower right region of mandible. Fine needle aspiration revealed no fluid. Both panoramic radiographs and a computed tomography scan revealed a mixed lesion with a multilocular appearance. Desmoplastic ameloblastoma was confirmed after an incisional biopsy. From teeth 41 to the angle of the jaw, a composite resection of the lesion was performed with segmental mandibulectomy. With a peek implant, it was repaired. The possibility for a problematic airway is emphasised in this case, with great surgical results.
 Conclusion: Desmoplastic ameloblastoma is a kind of ameloblastoma with unique clinic radiographic and histologic characteristics. Despite its rarity, the tumour necessitates a thorough examination due to the challenges it poses with airway ventilation and intubation.

Desmoplastic ameloblastoma in maxilla mimicking fibro-osseous leison: A case report

Desmoplastic Ameloblastoma accounts for 4% to 13% of all ameloblastomas and is a rare variant with high rate of recurrence. The desmoplastic variant of ameloblastoma usually appears in the anterior and premolar regions and sometimes resembles a benign fibro-osseous lesion showing a mixed radiolucent and radiopacity in the radiographic examination. Malignant transformation with repeated postsurgical recurrences have also been reported. In this paper we present a case of a 22-year-old female with swelling in the left upper jaw which turned out to be desmoplastic ameloblastoma. The pathologist and the clinician should be aware of the concepts and the association with malignant transformation and spread of the lesion in order to deliver appropriate treatment and to avoid further recurrences of the leison.

Prognostic significance of SOX2 and GPC3 in Ameloblastoma and its malignant counterpart (Ameloblastic Carcinoma)

Background: Ameloblastoma is a common benign aggressive odontogenic tumor with a tendency for high recurrence rate. Ameloblastic Carcinoma is the malignant counterpart of Ameloblastoma. However, they are usually difficult to be distinguished from one another. Therefore, using Immunohistochemical markers might be beneficial for diagnosing them accurately.Objective: Evaluation of SOX2 and GPC3 expressions as well as evaluating their roles in the tumorigenesis and the biological behavior of Ameloblastoma and Ameloblastic Carcinoma.Methods: Tissue samples are composed of 34 archived histopathologically confirmed cases of (19 Conventional Ameloblastomas, and 15 Ameloblatic Carcinomas). Sections were subjected to Immunohistochemical staining according to a standard protocol by applying antibodies to SOX2, and GPC3.Results: SOX2 and GPC3 expressions in recurrent Ameloblastoma were significantly higher than non- recurrent cases. Ameloblastic Carcinoma showed the highest immune-reactivity to SOX2 and GPC3 compared to the Conventional Ameloblastoma. Desmoplastic Ameloblastoma showed the highest scores of SOX2 and GPC3 compared to the other subtypes.Conclusions: SOX2 and GPC3 can be used as a panel for diagnosing the aggressive and the malignant odontogenic tumors accurately. Desmoplastic Ameloblastoma behaves more aggressively than other Conventional Ameloblastoma subtypes.

Desmoplastic Ameloblastoma- a Case Report

Abstract: Desmoplastic ameloblastoma is defined as locally invasive, intraosseous and a rare variant of ameloblastoma which show slight male predilection with prevalence within the fourth and fifth decades. Desmoplastic ameloblastoma (DA) is characterized by specific clinical, imaging, and histological features. We report a case of Desmoplastic ameloblastoma in a 28-year-old male with a painless swelling in the right anterior maxillary region. DA has greater predilection for maxilla with marked tendency for anterior region as compare to other variant of ameloblastoma which creates particular issues like expansion of lesion into maxillary sinus, high recurrence rate and proximity to important anatomical structures demands extra caution in the approach during treatment planning

Expression Profile of Stemness Markers CD138, Nestin and Alpha-SMA in Ameloblastic Tumours.

Ameloblastic carcinoma is a rare malignant odontogenic neoplasm with a poor prognosis. It can arise de novo or from a pre-existing ameloblastoma. Research into stemness marker expression in ameloblastic tumours is lacking. This study aimed to explore the immunohistochemical expression of stemness markers nestin, CD138, and alpha-smooth muscle actin (alpha-SMA) for the characterisation of ameloblastic tumours. Six cases of ameloblastoma and four cases of ameloblastic carcinoma were assessed, including one case of ameloblastic carcinoma arising from desmoplastic ameloblastoma. In all tumour samples, CD138 was positive, whilst alpha-SMA was negative. Nestin was negative in all but one tumour sample. Conversely, the presence or absence of these markers varied in stroma samples. Nestin was observed in one ameloblastic carcinoma stroma sample, whilst CD138 was positive in one ameloblastoma case, one desmoplastic ameloblastoma case, and in two ameloblastic carcinoma stroma samples. Finally, alpha-SMA was found positive only in the desmoplastic ameloblastoma stroma sample. Our results suggest nestin expression to be an indicator for ameloblastic carcinoma, and CD138 and alpha-SMA to be promising biomarkers for the malignant transformation of ameloblastoma. Our data showed that nestin, CD138, and alpha-SMA are novel biomarkers for a better understanding of the origins and behaviour of ameloblastic tumours.

Immunohistochemical evaluation of myofibroblasts in odontogenic keratocyst, dentigerous cyst and different clinical variants of ameloblastoma

Background: Odontogenic cysts and tumors exhibit varying degrees of aggressiveness in their biological behavior. Odontogenic keratocyst (OKC), dentigerous cyst (DC), ameloblastoma are most common odontogenic cysts and tumors to occur in the oral cavity. Myofibroblasts (MFs) in the connective tissue stroma participate in the matrix degradation process by secreting matrix metalloproteinase 2, transforming growth factor beta1 and may contribute to variation in their biological behavior. Its activity is identified by alpha-smooth muscle actin (α-SMA) marker. With this background, the present study aims to evaluate the frequency of MFs using α-SMA to determine the biological behavior of OKC, DC, and different clinical variants of ameloblastoma. Materials and Methods: A retrospective study was carried out with total of 60 samples which include 10 cases each of OKC, DC, 30 cases of different clinical variants of ameloblastomas and 10 normal mucosa taken as controls. All are stained immunohistochemically using α-SMA and were analyzed for the same. Comparison between more than 2 groups done by one way analysis of variance test with the level of significance of P ≤ 0.0001, i.e., <0.05. Results: Statistically significant difference in the mean number of MFs observed between certain groups, with higher mean number in solid ameloblastoma (SA) (32.45) followed by OKC (28.79), unicystic ameloblastoma (24.53), desmoplastic ameloblastoma (7.44), and DC (1.72). Conclusion: Higher frequency of MFs noticed in SA, OKC which are key cells for connective tissue remodeling by interacting with epithelial cells and other connective tissue cells to facilitate progression of cysts and tumors thereby contributing to their biological behavior.

A Case of Desmoplastic Ameloblastoma of Maxilla in Which MRI Was Used as a Reference for in Determining Extent of Resection

A Case of Desmoplastic Ameloblastoma of Maxilla in Which MRI Was Used as a Reference for in Determining Extent of Resection

Expression of Matrix Metalloproteinase-9 in Different Histopathological Variants of Ameloblastoma: A Cross-sectional Study

Introduction: Ameloblastomas are benign and the most common odontogenic neoplasms with many histopathological subtypes depending on the predominant pattern. They are known for their aggressive behaviour. As ameloblastomas have a high rate of recurrence, it is necessary to understand the biological behaviour of these neoplasms. Matrix Metalloproteinase-9 (MMP-9) is an enzyme that belongs to Metalloproteinases family and is known to degrade the Extracellular Matrix (ECM) and facilitate tumour progression. Evaluation of the expression of MMP-9 in ameloblastomas could contribute in understanding its biological behaviour. Aim: To analyse the expression of MMP-9 in different histopathological variants of ameloblastoma. Materials and Methods: A cross-sectional observational study was done in the Department of Oral Pathology and Microbiology, Bharati Vidyapeeth Deemed to be University, Dental College and Hospital, Pune, India. A total of 30 cases were selected for this study. The study was carried out for a duration of two years from April 2018 to April 2020. The MMP-9 expression was studied by immunohistochemical staining. The statistical comparison was done using Chi-square test between groups, p-value <0.05 was considered significant. The data was statistically analysed using Statistical Package for Social Sciences (SPSS) version 22.0, IBM Corporation, USA for MS Windows. Results: A total of 30 paraffin embedded archival tissue blocks were selected for this study. Among them nine cases were of Plexiform Ameloblastoma, eight of Unicystic Ameloblastoma, three of Acanthomatous Ameloblastoma, four of Desmoplastic Ameloblastoma and six were of Follicular Ameloblastomas. The MMP-9 showed variable expression in different histopathological subtypes of ameloblastoma. This difference was statistically significant between Plexiform and Acanthomatous as well as Plexiform and Follicular variants (p<0.05). A 66.7% (6 out of 9 samples) of Plexiform Ameloblastoma showed intense staining for MMP-9. Conclusion: Expression of MMP-9 varies in different histopathological variants of ameloblastoma and may not have an association with biological behaviour and aggressiveness.

Desmoplastic ameloblastoma in the mandible: A case report

Introduction: 0.9 – 12.1% of all cases of ameloblastoma account to be Desmoplastic Ameloblastoma (DA). The presentation of the tumor is often similar to benign fibro-osseous lesions both clinically as well as radiographically. Histologically, DA is made up of small nests and strands of odontogenic epithelium which seem to be compressed by the highly collagenized stroma. We report a case of DA in a 44-year-old female with a mildly painful swelling in the anterior region of mandible. The lesion had a multilocular appearance on both panoramic radiographs as well as in the computed tomography scan. Histologically, the lesion was confirmed to be a case of DA. Regardless of the fact that DA is a rare entity, its aggressive nature binds the clinician to be cautious enough to include DA in the differential diagnosis of any lesion/growth clinically and radiographically mimicking a benign fibro osseous lesion. Keywords: Ameloblastoma, Desmoplasia, Mandible.

SEGMENTAL RESECTION OF THE MANDIBLE FOR THE TREATMENT OF DESMOPLASTIC AMELOBLASTOMA: A CASE STUDY

The patient was referred to the buccomaxillofacial surgery and trauma unit, with a diagnosis of desmoplastic ameloblastoma after incisional biopsy, which was carried out in another department. An increase of the volume in the anterior region of the mandible, which was painless to the touch, was observed at the extra-oral physical examination. The intra-oral examination showed incisor crowding. During the tomographic exam, a multilocular radiolucent lesion, with irregular limits and root resorptions, was also observed. The segmental resection was carried out under general anesthesia with safety margin of 2 centimeters, through transcervical access. Two reconstructive plates were fixed to preserve the bed, as well as to strengthen the bone structure. Currently, after 2 postoperative years, the patient is undergoing outpatient follow-up, because the event of recurrence has been observed even after many years of the initial treatment and in mandibular reconstructive plans.

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.

Review of Ameloblastoma Case

Ameloblastoma is a benign epithelial neoplasm and ranges from 10% of the entire odontogenic tumor. Ameloblastoma is characterized by a slow growth pattern and can grow to a very large size and cause severe facial deformities. These tumors are most common at the age of the third and fourth decades, and most often occur in the posterior mandibular, especially in the third molar tooth, as well as associated with the impacted follicular or dental cyst. Classification of Ameloblastoma According to WHO distinguishable into benign ameloblastoma which include: (1) solid/multicystic ameloblastoma, (2) unicystic Ameloblastoma, (3) the peripheral (or extraosseous) ameloblastoma, (4) the desmoplastic ameloblastoma and malignant ameloblastoma based on the frequency sequence which includes: (a) metastasizing ameloblastoma, (b) Primary ameloblastic carcinoma, (c) Secondary intraosseous ameloblastic carcinoma, (d) secondary peripheral ameloblastic carcinoma. A radiological examination that can be conducted to diagnose ameloblastoma is plain photo, CT Scan and MRI. The image of Meloblastoma radiography may vary. Some of the depictions of lusent lesions are firmly, unilocular, well-orticated, which often relate to Corona tooth impacted or no eruption, so that it cannot be distinguished by odontogenic keratosis and dentigerous cysts on radiography. Some of the other, multilocular, internal septa and honey comb or soap appearance bubbles are often similar to the large odontogenic keratosis. However, only histopatological findings can help to determine the malignant tumors and the alteration of carcinomatose.