Adenoid ameloblastoma of the mandible: report of a new case of a distinct type of odontogenic neoplasms.

BACKGROUND

Adenoid ameloblastoma (AA) is a new type of odontogenic neoplasms added to the latest World Health Organization (WHO) classification. It has clinical course somewhat similar to ameloblastoma but yet more aggressive. Histopathologically, AA is formed of ameloblastomatous component arranged in a cribriform pattern, duct-like structures and whorled cellular condensations which make conventional ameloblastoma and adenomatoid odontogenic tumor in the main differential diagnosis. The clinical and radiographic features of AA are not characteristic which necessitate great care in histological examination. It is of paramount importance to distinguish between ameloblastoma with some glandular features and actual AA. Immunohistochemistry and/or molecular testing can provide definitive diagnosis of AA. Few cases of ameloblastoma with adenoid features were reported before considering AA as a separate entity. To the best of our knowledge, only two studies performed molecular testing and three studies used supporting immunohistochemical markers of AA.

CASE PRESENTATION: We report a case of a 19-year-old male patient who was presented with a painful swelling in the left side of the mandible for a period of four months. Past medical history and dental history were free. Radiographic examination showed multilocular radiolucency. Incisional biopsy revealed Ameloblastoma. Wide surgical excision was done. Microscopic examination of the surgical specimen showed histopathological features providing the diagnosis of AA. We further carried out immunohistochemistry to support the diagnosis. Intermaxillary fixation for a period of 4 weeks was carried out using wires for jaw stabilization and maintaining proper bite. The patient was followed up regularly every one month.

CONCLUSIONS

Reporting of new cases of AA is of paramount importance for both surgeons and pathologists that increases their awareness about AA which is more aggressive than conventional ameloblastoma and thus, providing accurate management.