Hybrid Ameloblastoma Research Articles

A Hybrid Ameloblastoma in Posterıor Mandible: A Case Report

Objective: Hybrid ameloblastoma refers to the tumors that contain two or more different histologic types of ameloblastoma. Till date, only 49 cases of hybrid ameloblastoma with different combinations have been reported. Here we present a case of hybrid ameloblastoma containing follicular, plexiform, and acanthomatous types. Case Report: A 24-year-old male patient referred to our clinic with a slow-growing asymptomatic swelling on the right side of the mandible. Radiographic assessment revealed a well-defined radiolucent lesion associated with an impacted third molar. Following incisional biopsy, which was compatible with ameloblastoma, total excision of the lesion along with Carnoy fixation was performed. Final histopathologic assessment revealed a hybrid ameloblastic lesion which contained follicular, plexiform, and acanthomatous types. Conclusion: Hybrid ameloblastoma has variable clinical, radiological, and histopathological presentation. As a rare entity, the biological behavior of the lesion still needs to be analyzed extensively with further clinical research. Keywords: Carnoy, Enucleation, Hybrid ameloblastoma.

Hybrid ameloblastoma and odontogenic keratocyst in a patient with Gorlin-Goltz syndrome: case report

Introduction: Hybrid odontogenic lesions combine characteristics of two or more lesions in a single site, and they are considered a rare condition. The occurrence of these lesions in patients with Gorlin-Goltz syndrome is even less common. Since the lesion has variable clinical aspects and multiple imaging characteristics, histopathological examination is mandatory for a definitive diagnosis. Methods: This article reports the case of a patient with Gorlin-Goltz syndrome, who had multiple odontogenic keratocysts in the mandible and maxilla, as well as a combined/hybrid ameloblastoma and odontogenic keratocyst lesion. Results: Distinct areas with histological patterns characteristic of the cyst and tumor were observed within the same lesion. Conclusion: This unusual but still possible diagnosis should be considered by pathologists and oral and maxillofacial surgeons when evaluating, diagnosing and treating patients with syndromes characterized by odontogenic lesions.

Modifications of Gallego staining and its dental application.

The objectives of the study are to employ modified Gallego staining in pathology and to specifically evaluate the hard tissue apposed to odontogenic epithelium in order to aid in the diagnosis. Lillie's modification of Gallego's stain was utilized as a reference to create a fresh batch of the stain. The archival and running cases of 2021-2022 was screened for odontogenic pathologies, yielding approximately 46 cases, among these four cases were selected which required evaluation of the hard tissue matrix apposed to odontogenic epithelium for its characterization. The modified Gallego staining was employed in the soft tissue sections of these cases under controlled environment. The staining results were evaluated. The stain was used in cases to stain dentinoid deposition as green color in hybrid ameloblastoma, archegonous cystic odontoma, dentinogenic ghost cell tumor and also in other cases like calcifying odontogenic cyst. Bone presented as green in color, cells as pink color and collagen as green-pink. This helped in the correct diagnosis of these cases facilitating the correct treatment modality. In the field of oral pathology, there are a multitude of lesions which are odontogenic with the diagnosis of few of them hinging on the characterization of hard tissue matrix found in close approximation to odontogenic epithelium implying an inductive capability to the odontogenic epithelium. This particular modified Gallego stain has been able to help in diagnosis of few such cases in our repertoire of cases.

Comparative study of behavior between Conventional Ameloblastoma and Hybrid Ameloblastoma

Comparative study of behavior between Conventional Ameloblastoma and Hybrid Ameloblastoma

Hybrid Ameloblastoma Arising from a Treated Odontogenic Keratocyst of the Mandible: A Case Report With Literature Review.

Odontogenic Keratocyst (OKC) is an odontogenic cyst of developmental origin arising from remnants of the dental lamina. Malignant or benign transformations though rare have been noticed from their epithelium. Ameloblastomatous transformation from an OKC is extremely rare with such lesions being referred to as combined/"hybrid" odontogenic lesions. In this article, we present an intriguing case of a 60-year-old male who was operated on for OKC of the anterior mandible 3years before, who came back with a complaint of swelling over the same site. Incisional biopsy revealed the acanthomatous type of ameloblastoma for which segmental resection with immediate reconstruction using recon plate was done. Excision biopsy revealed a plexiform variant as well, thus exhibiting a hybrid pattern. Surgeons should be aware of this hybrid presentation of ameloblastoma arising from the epithelium of OKC as the acanthomatous subtype is known for its notorious genetic behavior leading to recurrence and aggressive nature of this tumor.

Diagnostic Enigma of Adenoid Ameloblastoma: Literature Review Based Evidence to Consider It as a New Sub Type of Ameloblastoma.

Adenoid ameloblastoma is a hybrid odontogenic tumour showing histopathological features of both ameloblastoma and adenomatoid odontogenic tumour (AOT), with approximately 40 cases reported in the literature. The aims of the report are to illustrate the diagnostic challenges of adenoid ameloblastoma using three new cases and to analyze evidence in literature to consider adenoid ameloblastoma as a new sub type of ameloblastoma. A literature review was performed with the key words-adenoid ameloblastoma, hybrid/composite odontogenic tumours, hybrid ameloblastoma and adenomatoid odontogenic tumour, ameloblastoma with inductive changes, dentinoid and dentinoma to select the cases compatible with the diagnosis of adenoid ameloblastoma. Out of the 40 cases reported in literature, 31 cases with sufficient information and 3 new cases were analyzed. Out of the 34 adenoid ameloblastomas majority of tumours (76.5%) occurred in adults with age ranging from 25 to 55years. Slight female predilection with a male:female ratio of 0.9:1 was observed. Approximately, 64.7% occurred in the mandible. Radiologically, 82.4% of adenoid ameloblastomas presented as radiolucent lesions while 47.1% occurred with ill-defined margins and cortical perforation at diagnosis. Histopathologically, 70.8% of tumours presented as plexiform ameloblastomas, while duct like structures/glandular structures were the commonest feature supportive of adenomatoid odontogenic tumour observed in overwhelming majority of 95.9% of adenoid ameloblastomas. 91.6% of tumours showed inductive change in the form of dentinoid. Further, 45.4% of the tumours developed at least one recurrence following surgical excision. The report presents literature review based evidence to show the existence of adenoid ameloblastoma, which is demographically similar to conventional ameloblastoma but with histopathological differences and presenting with higher rate/multiple recurrences, indicating its biological aggressiveness. Thus, we would like to propose the inclusion of adenoid ameloblastoma as a sub type of ameloblastoma in the next revision of the WHO odontogenic tumour classification.

Hybrid ameloblastoma and central giant cell lesion: Challenge of early diagnosis

Hybrid lesions encompass the occurrence of different entities in one lesion. A 67-year-old woman was referred to the Oral and Maxillofacial Surgery Service for treatment of mandibular Central Giant Cell Lesion (CGCL) previously diagnosed. Intraoral examination revealed edentulism and a painless swelling extending from the alveolar ridge to the buccal vestibule with hard consistency covered by normal mucosae, with unknown duration. Panoramic radiograph revealed a large, multilocular and well-defined radiolucent lesion extending from the region of left mandibular lateral incisor teeth to right mandibular first molar with no evidence of osseous perforation. Initially, a treatment with intralesional injection of corticosteroids was performed. After 18 months of treatment, an increase in size of the osteolytic lesion was noted. An incisional biopsy was carried out and the microscopic examination revealed a unicystic ameloblastoma associated to CGCL. It was performed marsupialization and later the enucleation of residual lesion. The follow-up remains being performed. Key words:Hybrid lesion, central giant cell lesion, ameloblastoma.

Hybrid ameloblastoma of the maxilla: A case report and review of literature

The desmoplastic variant is a rare form which represents about 4 - 5 % of all ameloblastomas. A few number of studies in the literature have reported “hybrid lesions” which show features of both desmoplastic and conventional ameloblastoma. In this report, we introduce a novel case of hybrid desmoplastic/follicular ameloblastoma of the maxilla, presenting its clinical, radiographic and histopathological features. It has been reported that the desmoplastic variant has a more aggressive behavior than conventional ameloblastoma, owing to its predilection to expand into a large size when affecting the maxilla and the tendency to early invade the surrounding structuresDespite the rarity of desmoplastic ameloblastoma and “hybrid ameloblastoma”, they should be included in the differential diagnosis of slowly growing lesions especially those in the anterior and premolar regions of the jaw. Careful radiographic investigation and accurate histopathological examination of properly taken incisional biopsies will help in providing patients with the best therapeutic option and avoiding waste of time and cost associated with misdiagnosis.

Rare variant of ameloblastoma: A case report

Ameloblastoma is second most common odontogenic tumor of jaws that presents with typical clinical, radiological, and histopathological appearances. Provisional diagnosis of this tumor is based on clinical and radiological features; however, final diagnosis is made by histopathological examination which classifies it in to various types, i.e. follicular, plexiform, acanthomatous, granular cell, desmoplastic, and basal cell type. Follicular and plexiform patterns are most common. Hybrid ameloblastoma (HA) is rare entity in which conventional types (follicular and plexiform) of ameloblastoma co-exist with desmoplastic ameloblastoma (DA). Its radiological appearance differs from conventional ameloblastomas and sometimes resembles fibro-osseous lesions (FOL). There are only 35 cases of HA reported in literature. We present a novel case of hybrid desmoplastic/follicular ameloblastoma of anterior mandible with emphasis on its radiologic features. Differential diagnosis of the lesion from conventional ameloblastomas and FOL are discussed.

Unicystic Ameloblastoma Developing into a Hybrid Lesion of Rare Entity - with Review of Literature

Existence of unicystic ameloblastoma with desmoplasia is a seldom occurrence. It was first described by Waldron and El-Mofty in the year 1987 as the term hybrid ameloblastoma. Here, we account a case of hybrid lesion depicting outstanding unicystic, follicular ameloblastoma with desmoplasia and mucus cell differentiation showing inductive changes. The patient is a 38-year-old male with a swelling in the lower right posterior region of the jaw. Radiologically, a mixed radiopaque-radiolucent lesion was sighted in this region. Taking into account of patient's complaint, clinical, radiographic, and histologic features; diagnosis of ameloblastic fibrodentinoma was made. It was followed by complete excision of the tumor. The challenge in the management of this tumor was to render complete excision as recurrence may occur in incomplete removal and also to reconstruct the bony defect to give a moderate cosmetic and functional result to the patient. The excisional biopsy report was established to be of hybrid ameloblastoma. Since there are few cases reported in the past of this lesion, the present case is an addition for better perception of this odontogenic tumor. This article identifies some profound concepts and new developments in the histopathologic design of ameloblastoma and its hybrid variant. It also briefly reviews the literature referring to this rare tumor entity. Considering the characteristics of ameloblastoma, priority of surgical management for hybrid lesion is also described.

Hybrid Odontogenic Carcinoma Arising from A Hybrid Ameloblastoma and Keratocyst Odontogenic Tumor: A Case Report and Review of the Literature

Hybrid Odontogenic Carcinoma Arising from A Hybrid Ameloblastoma and Keratocyst Odontogenic Tumor: A Case Report and Review of the Literature

Desmoplastic hybrid ameloblastoma presenting as a fibrous epulis

Desmoplastic ameloblastoma (DA) is a rare variant of ameloblastoma with specific clinical, imaging, and histological features. Histologically, it is characterized by extensive stromal desmoplasia with small compressed nests and strands of odontogenic epithelium. The purpose of this article is to present a case of central DA that showed unusual clinical presentation of a classic solid/multicystic ameloblastoma occurring as a peripheral lesion in the form of gingival epulis, arising from extraction site and showed histopathological feature of a hybrid variant.

Hybrid ameloblastoma and adenomatoid odontogenic tumor: report of a case and review of hybrid variations in the literature

Hybrid odontogenic tumors including 2 or more different histologic types have been documented, but their occurrences are not very common. We present a case of hybrid odontogenic tumor composed of ameloblastoma and adenomatoid odontogenic tumor (AOT) arising in the mandibular molar region of a 31-year-old Japanese woman who had a history of familial adenomatous polyposis. The tumor, measuring 10 mm in diameter, was surgically removed from the alveolar bone. Histopathologically, the tumor consisted of both follicular and plexiform types of ameloblastoma in which multiple and smaller foci of AOT were intermingled. There have been 3 reported cases of hybrid ameloblastoma and AOT, all of which presented unicystic types as ameloblastoma components. This, however, is the first report of a hybrid tumor containing an authentic solid-type ameloblastoma compartment and an AOT compartment in a patient with a background of familial adenomatous polyposis.

Hybrid ameloblastoma in a nigerian: Report of a case and review of literature

Background: Hybrid Ameloblastoma is a rare type of ameloblastoma that is presently receiving attention in some quarters. Altogether, less than 30 cases have been reported in the scientific literature, thus calling for the need to report more cases in order to add to the body of knowledge on this lesion. This case report is aimed to add to the number of cases that are building up in the scientific literature. Materials and Methods: A 50-year-old female presented with a 3-year history of an anterior mandibular swelling extending from the body of the mandible on the right to the body of the mandible on the left. Orthopantomograph of the lesion revealed a mixed radiolucent and radiopaque lesion that extended from the distal region of the right mandibular second premolar to distal region of the left mandibular second molar. Segmental mandibulectomy with immediate replacement with reconstruction was undertaken. Results: Specimen which was subjected to histopathologic examination reported a diagnosis of Keratinizing Follicular Ameloblastoma and Desmoplastic Ameloblastoma with Osteoplasia, consistent with a diagnosis of Hybrid Ameloblastoma. There has been no sign of recurrence 7 months after a regular follow-up and the patient is planned for a long term follow-up. Conclusion: Besides histological details that combine both conventional ameloblastoma and desmoplastic ameloblastoma, the present case of hybrid ameloblastoma bears similar clinical features as well as treatment modalities to that of conventional solid multicystic ameloblastoma.