Among the ameloblastomas, the desmoplastic variation is rare. The desmoplastic ameloblastoma (DA) is characterized by specific clinical, imaging, and. Desmoplastic ameloblastoma (DA) is a rare variant of ameloblastoma, and less than patients have been reported in the literature. The present case. Desmoplastic Ameloblastoma is a rare variant of ameloblastoma. 90 cases of desmoplastic ameloblastoma have been reported so far in literature. We are.
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Desmoplastic ameloblastoma is a relatively rare variety of ameloblastoma and only very few cases have been reported so far.
The present case is an elderly man who had reported with a swelling in the anterior mandible which turned up to be desmoplastic ameloblastoma. Proper diagnosis is necessary to report such a case, so that the actual incidence can be noted.
The tumors that arise from odontogenic epithelium are called as ameloblastomas. Its histopathologic types are plexiform, follicular, acanthomatous, granular, and desmoplastic. This feature makes it unique among the ameloblastomas.
The patient had noticed the swelling 5 months back, which had slowly increased to the present size.
On extraoral examination, noticeable facial asymmetry was observed due to swelling present on the right side of the mandible. The right submandibular lymph node was also palpable and non-tender. On intraoral examination, there was an ill-defined solitary swelling extending from the mesial aspect of 31 to the mesial aspect of 45, superioinferiorly extending from the superior margin of attached gingival to well beyond the gingival sulcus.
Radiographic examination revealed a mixed radiolucency interspersed with radiopacities with ill-defined borders. The lower border of the mandible was preserved so that the aesthetic and functional work-up could be done [ Figure 5 ]. The cut surface was solid and whitish in most cases. The epithelial tumor islands were very irregular with a pointed stellate appearance or small strand like and discrete.
Histopathology showing odontogenic epithelium like areas in between dense collagen tissue fibers. Hypercellularity of spindle-shaped or polygonal cells and microcyst formation is seen focally. The gross specimen most often consists of resected portions of jaws.
Ameloblasstoma ameloblastoma s is found predominantly in anterior or premolar regions of the jaws. It is smaller in size than other types of ameloblastoma, and occurs mainly in the aneloblastoma region and occupies the tooth-bearing area. This variant exhibits no typical findings of ameloblastoma. The oxytalan fibers in the stromal tissue suggest that the tumor derived from the epithelial rest of Malassez in the periodontal membrane of a related tooth.
The periphery of islands consists of cuboidal cells with hyperchromatic nuclei.
The columnar cells with reversed nuclear polarity are rarely conspicuous. The central area consists wmeloblastoma swirled, hypercellular, spindle-shaped, or squamous epithelial cells.
Microcysts that contain eosinophilic amorphous deposits or appear empty may occur centrally. Formation of metaplastic osteoid trabeculae osteoplasia may be present. Evidence of a capsule is not found. In the immunoprofile, the tumor cells exhibit variable expression of S protein and desmin, similar to other types of solid multicystic a meloblastoma SMA.
Keratin immunoreactivity is confined to the tumor cells showing squamous differentiation. Decreased expression of CK19 and high expression of p63 is observed.
Differences in expression are attributed to diverse factors such as dedifferentiation or rate of proliferation of neoplastic cells, inherent cellular potential, or extracellular mediators. Treatment is by resection Long-term follow-up is a must after initial treatment.
As desmoplastic ameloblastoma is an uncommon lesion, it warrants proper diagnosis and treatment. National Center for Biotechnology InformationU. Author information Article notes Copyright and Desmoplwstic information Disclaimer.
Received Jan 26; Accepted Apr This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. This article has been cited by other articles in PMC. Abstract Desmoplastic ameloblastoma is a relatively rare variety of ameloblastoma and only very few cases have been reported so far. Ameloblastoma, anterior, desmoplastic, mandible.
Open in a separate window. Footnotes Source of Support: Head and Neck Tumors. World Health Organization Classification of Tumors. Pathology and Genetics of Head and Neck Tumors.
Desmoplastic ameloblastoma in the mandible. A repeatedly recurrent desmoplastic ameloblastoma after removal and allobone graft: Radiographic features compared with histological changes. Odontogenic Tumors and Allied Lesions. Benign neoplasm’s and tumor-like lesions arising from the odontogenic apparatus showing odontogenic epithelium with mature fibrous stroma, without ectomesenchyme; p.
Desmoplastic ameloblastoma with osteoplasia: Review of ameloblastomq with a case report. J Oral Maxillofac Pathol.
Pathology Outlines – Benign tumors / tumor-like conditions: ameloblastoma
Immunohistochemical profiling of ameloblastomas using cytokeratin, vimentin, smooth muscle actin, CD34 and S Matsuo A, Ueno S. Immunohistochemical demonstration of keratin in ameloblastoma as an ameloblasstoma of tumor differentiation. J Oral Maxillofac Surg.