Acanthomatous ameloblastoma--a case report.
INTRODUCTION: Ameloblastoma is a benign tumor, accounting for 1% of all the tumors of the jaw and 18% of odontogenic tumors. Acanthomatous ameloblastoma is a rare variant of follicular ameloblastoma with squamous metaplasia. Here with we are presenting a case of acanthomatous ameloblastoma.
CASE REPORT: A 35 year female presented with swelling in the right side of the ramus of mandible measuring 2.5 X 2 cm. X-ray--unilocular cystic swelling.
GROSS: examination revealed unilocular cystic mass with a rough hemorrhagic external surface. Cut section--Wall thickened grey white, luminal surface is ragged with punctate hemorrhages (fig-01).
MICROSCOPY: H & E stained sections show Islands of odontogenic epithelium within a fibrous stroma. The islands are composed of basophilic columnar cell at periphery, exhibiting reverse polarization of nuclei away from the connective tissue with vacuolization (fig-02). The central area is less cellular, edematous, resembling stellate reticulum. There are areas showing squamous epithelial metaplasia (fig-03).
DISCUSSION: Ameloblastomas are derived from the ameloblasts or dental lamina. The WHO has classified several histopathologic subtypes. Acanthomatous ameloblastoma is a rare variant of follicular ameloblastoma with squamous metaplasia and even keratinization are seen in the stellate reticulum area. It has a 26% recurrence rate. The differential diagnosis for this entity includes ameloblastic fibroma, squamous cell carcinoma and basal cell carcinoma. Treatment consists of adequate tumor removal including margin of uninvolved tissue with long term follow up.
CONCLUSIONS: Acanthomatous Ameloblastoma is a very rare tumor. Timely recognition and surgical intervention of ameloblastomas may improve treatment outcomes and may also diminish morbidity and recurrence.
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Rajshekhar Jewargikar, S. S. Inamdar, V. L. Pattankar, Viral B. Laheru
[1.] Professor. Department of Pathology, M.R. Medical College, Gulbarga, Karnataka, India.
[2.] Professor. Department of Pathology, M.R. Medical College, Gulbarga, Karnataka, India.
[3.] Professor & HOD. Department of Pathology, KBN Medical College, Gulbarga, Karnataka, India.
[4.] Post Graduate. Department of Pathology, M.R. Medical College, Gulbarga, Karnataka, India.
Dr. Rajshekhar Jewargikar, Professor, Department of Pathology, M. R. Medical College, Sedam Road, Gulbarga--585105, Karnataka, India.
Ph: 0091 9916912789
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|Title Annotation:||CASE REPORT|
|Author:||Jewargikar, Rajshekhar; Inamdar, S.S.; Pattankar, V.L.; Laheru, Viral B.|
|Publication:||Journal of Evolution of Medical and Dental Sciences|
|Article Type:||Clinical report|
|Date:||Mar 11, 2013|
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