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A. Histopathologic exam shows numerous dystrophic calcifications and keratin pearls (H&E stain, original magnification × 40). B. Acanthomatous ameloblastoma showing squamous differentiation of epithelial nest (H&E stain, original magnification × 200).
Source publication
This report presents a rare case of ameloblastoma with histopathologic and radiographic calcification, including 3-dimensional cone-beam computed tomographic (CBCT) images. A 22-year-old woman had hard swelling on the right mandible. Panoramic and CBCT images showed multilocular radiolucencies with internal calcification foci in the right mandible....
Contexts in source publication
Context 1
... seen on 3-dimensional (3D) images at various angles (Figs. 2 and 3). The differential diagnosis included ameloblastoma and odontogenic keratocyst. Histopathologically, the lesion showed some central squamous differentiation and more densely packed peripheral palisading ameloblastic cells, with many areas of keratin pearls and calcifications (Fig. 4). The histopathologic diagnosis was acanthomatous ameloblastoma with dystrophic calcification. The patient underwent segmental mandibulectomy and reconstruction with a fibular osseous free bone graft on the lesion, and dental implant treatment finished in ...
Context 2
... was found among 82 cases of ameloblastoma. The small radiopacities indicating calcification could be found even on panoramic radiography in this case. The CBCT images showed many scattered definite radiopaque foci of calcification. Some calcifications measured approximately 0.3 mm and were found in clusters on the histopathologic examination (Fig. ...
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The origin of ameloblastic fibrosarcoma (AFS) or ameloblastic dentinosarcoma in the background of ameloblastic fibroma has been widely reported in literature. To the best of our knowledge, the malignant transformation of a benign ameloblastoma to an aggressive variety of AFS has never been reported. Here, we report a rare case of follicular amelobl...
Citations
... When the tumor reaches large proportions, deformity, masticatory dysfunction, facial asymmetry, opening limitation, or airway obstruction are observed. These features mean the clinical diagnosis will be more predictable; however, at these stages, the prognosis and quality of life of the patient are reserved, since radical surgical intervention is the alternative to his treatment [8][9][10][11][12]. ...
Ameloblastoma is a rare benign epithelial odontogenic neoplasm, but with great clinical implications, as despite its benignity and slow growth, most cases are locally aggressive with a significant recurrence rate. Histological, cellular, or molecular analyses of its pathogenesis have confirmed the complexity of this neoplasm. We present the case of a 20-year-old patient with a suggestive clinical and radiographic diagnosis of ameloblastoma. An incisional biopsy was obtained confirming the diagnosis of conventional ameloblastoma. Left hemimandibulectomy and plate reconstruction were performed. Histopathological analysis of the surgical specimen confirmed the conventional ameloblastoma with a plexiform pattern and significant areas of cystic degeneration and amyloid-like-like deposits. Additionally, a microarray was carried out with bioinformatic analysis for the enrichment, protein interaction, and determination of eight hub genes (CRP, BCHE, APP, AKT1, AGT, ACTC1, ADAM10, and APOA2) related to their pathogenesis.
... An exception is the desmoplastic variant of ameloblastoma, which often presents as a mixed density lesion [39]. Dystrophic calcifications could explain the mixed radiologic appearance seen in some ameloblastomas, particularly the acanthomatous variant [40]. In KA, the mixed radiologic appearance is due to the extensive keratin production undergoing dystrophic calcification. ...
Background
Keratoameloblastoma (KA) is an uncommon and controversial variant of ameloblastoma exhibiting central keratinisation. Due to their rarity, there is limited information in the literature on their clinical, radiologic and histologic features. This study adds seven additional cases of KA to the literature, and reviews the current published literature on this rare entity.
Methods
KAs were retrospectively reviewed over a 20-year period from three Oral and Maxillofacial Pathology Laboratories. Included cases were examined and the diagnosis confirmed under conventional microscopy. Immunohistochemistry with the use of a monoclonal antibody against calretinin was performed on included cases. The clinical, radiologic and histologic features of the seven new cases of KA were analysed and compared to existing cases in the literature.
Results
KAs presented at a mean age of 40 years with a nearly equal gender distribution and a mandibular predilection (65%). The majority (92%) of cases presented with localised swelling with associated pain in 32% of cases. Mixed density or internal calcifications were noted in 40% of cases. All tumours presented with bony expansion, with cortical destruction noted in 62% of cases. Histologically, all tumours consisted of solid and cystic follicles with surface parakeratinisation and lamellated accumulations of central keratin. In areas the cystic follicles had an epithelial lining suggestive of an OKC. There were focal luminal areas of loosely arranged polygonal cells reminiscent of the stellate reticulum. The basal cells consisted of columnar cells with evidence of palisading and prominent subnuclear vacuolisation. Of the cases treated via tumour resection, 27% presented with tumour recurrence.
Conclusion
This case series reports seven additional cases of KA, taking the total to 26 reported cases. The identification of subtle histologic features, including focal stellate reticulum-like central areas, subnuclear vacuolisation and lamellated-type central keratinisation, are key in diagnosing KA. The radiologic features will often indicate signs of aggressiveness such as cortical destruction, differentiating KA from OKC. All cases were completely negative for calretinin IHC, limiting its use in distinguishing KA from OKC. Further large series are needed to expand the current understanding of this rare variant of ameloblastoma.
Background
The purpose of the current study was to report on the clinical presentation and radiologic features of 155 cases of ameloblastoma (AB), representing a detailed, large, single‐centre radiologic study.
Methods
Histologically confirmed cases were reviewed over 11 years. Demographic and clinical data were retrieved from the patient's records. Radiologic information was analysed from available radiographs. The radiologic features of ABs were assessed according to the mean age of presentation and the mean duration of the lesion. The distinguishing radiologic features between adults/children and sex were also evaluated.
Results
A statistically significant correlation existed between loss of border demarcation and advanced mean age. Multilocular lesions were markedly more common in adults compared to children. Multilocular ABs were associated with increased lesion duration and advanced mean age. Radiologic signs of reactive bony changes associated with the tumour presented at the highest mean duration of all bony effects. Bony expansion and cortical destruction were statistically correlated with lesion duration. Tooth impaction was more common in children. Some mandibular lesions reached a significant size, resulting in impingement of the maxillary sinus, zygoma, orbit and pterygoid plates.
Conclusion
Due to unfortunate healthcare access constraints, ABs grow to significant sizes and exhibit features not often reported in the literature. The findings of this analysis highlighted the radiologic features of ABs expressed through the mean age and duration of the lesion. This emphasises the significance of timely management of these lesions.
