ADENOID AMELOBLASTOMA WITH DENTINOID: A CASE REPORT

Abstract

Adenoid ameloblastoma with dentinoid (AAD) has been considered a very rare variant of ameloblastoma showing histopathologic features similar to adenomatoid odontogenic tumor (AOT) along with apparent dentinoid formation. Since the first use of this term by Brannon in 1994, however, there has been no official recognition of this entity as shown in both the 3rd and 4th edition of WHO classification of odontogenic tumors in 2005 and 2017. Because less than 20 cases of AAD have been reported to date, clinical behavior and optimal treatment modalities of AAD are still uncertain. Here we present an additional case of AAD with recurrence 10 years after the initial treatment. A 39-year-old male was referred to department of oral and maxillofacial surgery, complaining of pain and mobility of teeth in the right posterior maxilla. Panoramic radiograph revealed a unilocular radiolucency with relatively well-defined borders extending from the second premolar to the second molar. Root resorptions of the affected teeth were found. Mass excision was performed and the diagnosis of epithelial odontogenic ghost cell tumor was made. Ten years later, he presented with the recurrent lesion at the same area. CT view showed destructive enhancing mass suspicious for malignancy at the right posterior maxilla. Radically resected mass was diagnosed as adenoid ameloblastoma with dentinoid/osteodentin as it showed lots of duct-like structures with ameloblastoma-like features along with numerous dentinoid formation, but there were no ghost cells.