Desmoplastic Ameloblastoma: A Case Report
Abstract
Ameloblastoma is the most common odontogenic tumor of epithelial tissue origin. There are various types of Ameloblastomas. In that, Desmoplastic ameloblastoma is one of the rare variant of ameloblastoma. Because of its rare occurrence, exact nature of the lesion yet to know. Hence nature of the Desmoplastic ameloblastoma need to be highlighted.
We report a case of desmoplastic ameloblastoma in a 45-year-old female with a painless swelling in the anterior Mandibular region. Panoramic radiographs showed a mixed lesion with multilocular appearance. Histopathological presentation revel Desmoplastic ameloblastoma.
Key words: Desmoplastic ameloblastoma, odontogenic tumor, stromal desmoplasia. …show more content…
The following features are usually observed during microscopic examination: 1) Stromal desmoplasia, in the form of moderately cellular, fibrous connective tissue with abundant collagen, which is the most consistent, and distinguishing feature; 2) Islands of different shapes in the epithelial component; 3) peripheral layer of cuboidal cells; and 4) Hypercellular central area composed of spindle shaped or polygonal epithelial cells. Present case was consistent with these common features reported in the literature. Desmoplastic ameloblastoma exhibits a more aggressive behavior than other types of ameloblastoma. This aggressiveness may be due to 1) potential to grow to a large size; 2) the common location in the maxilla leading to an early invasion of adjacent structures; 3) the diffuse radiographic appearance, and 4) histological finding of bone invasion.11
Histologically, the tumor might be misdiagnosed as another odontogenic tumor, as the characteristic palisading layer of ameloblastoma may not be pre-sent in all the epithelial clusters, particularly if the biopsy specimen is small. Areas with only narrow strands of epithelial cells within desmoplastic stroma may simulate odontogenic fibroma. The importance lies in the differences in the clinical behavior and management of these two tumors. Ameloblastoma is a potentially aggressive tumor that requires enbloc resection. …show more content…
For proper understanding of such cases, more in depth analysis and long term follow up is required. The clinician has to be alert regarding the unusual presentation of this neoplasm and should include desmoplastic ameloblastoma as differential diagnosis in any lesion ranging from simple abscess to any fibro-osseous lesions/neoplastic growth presenting in anterior maxilla/mandible. The definite diagnosis requires histopathological examination. Also with the potential for recurrence, such cases should always be treated by complete
Abstract
Ameloblastoma is the most common odontogenic tumor of epithelial tissue origin. There are various types of Ameloblastomas. In that, Desmoplastic ameloblastoma is one of the rare variant of ameloblastoma. Because of its rare occurrence, exact nature of the lesion yet to know. Hence nature of the Desmoplastic ameloblastoma need to be highlighted.
We report a case of desmoplastic ameloblastoma in a 45-year-old female with a painless swelling in the anterior Mandibular region. Panoramic radiographs showed a mixed lesion with multilocular appearance. Histopathological presentation revel Desmoplastic ameloblastoma.
Key words: Desmoplastic ameloblastoma, odontogenic tumor, stromal desmoplasia. …show more content…
The following features are usually observed during microscopic examination: 1) Stromal desmoplasia, in the form of moderately cellular, fibrous connective tissue with abundant collagen, which is the most consistent, and distinguishing feature; 2) Islands of different shapes in the epithelial component; 3) peripheral layer of cuboidal cells; and 4) Hypercellular central area composed of spindle shaped or polygonal epithelial cells. Present case was consistent with these common features reported in the literature. Desmoplastic ameloblastoma exhibits a more aggressive behavior than other types of ameloblastoma. This aggressiveness may be due to 1) potential to grow to a large size; 2) the common location in the maxilla leading to an early invasion of adjacent structures; 3) the diffuse radiographic appearance, and 4) histological finding of bone invasion.11
Histologically, the tumor might be misdiagnosed as another odontogenic tumor, as the characteristic palisading layer of ameloblastoma may not be pre-sent in all the epithelial clusters, particularly if the biopsy specimen is small. Areas with only narrow strands of epithelial cells within desmoplastic stroma may simulate odontogenic fibroma. The importance lies in the differences in the clinical behavior and management of these two tumors. Ameloblastoma is a potentially aggressive tumor that requires enbloc resection. …show more content…
For proper understanding of such cases, more in depth analysis and long term follow up is required. The clinician has to be alert regarding the unusual presentation of this neoplasm and should include desmoplastic ameloblastoma as differential diagnosis in any lesion ranging from simple abscess to any fibro-osseous lesions/neoplastic growth presenting in anterior maxilla/mandible. The definite diagnosis requires histopathological examination. Also with the potential for recurrence, such cases should always be treated by complete