A Hybrid Ameloblastoma in Posterıor Mandible: A Case Report

Abstract

Objective: Hybrid ameloblastoma refers to the tumors that contain two or more different histologic types of ameloblastoma. Till date, only 49 cases of hybrid ameloblastoma with different combinations have been reported. Here we present a case of hybrid ameloblastoma containing follicular, plexiform, and acanthomatous types. Case Report: A 24-year-old male patient referred to our clinic with a slow-growing asymptomatic swelling on the right side of the mandible. Radiographic assessment revealed a well-defined radiolucent lesion associated with an impacted third molar. Following incisional biopsy, which was compatible with ameloblastoma, total excision of the lesion along with Carnoy fixation was performed. Final histopathologic assessment revealed a hybrid ameloblastic lesion which contained follicular, plexiform, and acanthomatous types. Conclusion: Hybrid ameloblastoma has variable clinical, radiological, and histopathological presentation. As a rare entity, the biological behavior of the lesion still needs to be analyzed extensively with further clinical research. Keywords: Carnoy, Enucleation, Hybrid ameloblastoma.

Keywords

• Carnoy
• Enucleation
• Hybrid ameloblastoma

Posterior Mandibulada Hibrit Ameloblastoma: Olgu Sunumu

Abstract

Amaç: Hibrit ameloblastoma, iki veya daha fazla farklı histolojik ameloblastoma alt tipini içeren tümörleri ifade eder. Bugüne kadar, farklı kombinasyonlara sahip sadece 49 hibrit ameloblastoma vakası bildirilmiştir. Burada foliküler, pleksiform ve akantomatoz alt tipler içeren bir hibrit ameloblastom vakası sunulmaktadır. Olgu Sunumu: 24 yaşında erkek hasta, kliniğimize mandibulanın sağ tarafında yavaş büyüyen ağrı ve pü akışının eşlik ettiği, sert şişlik şikayeti ile başvurdu. Radyografik değerlendirmede, gömülü üçüncü molar diş ile ilişkili iyi sınırlı bir radyolüsent lezyon saptandı. Ameloblastoma ile uyumlu insizyonel biyopsi sonrası lezyonun total eksizyonu ve Carnoy solüsyonu ile kimyasal fiksasyon uygulandı. Nihai histopatolojik değerlendirme, foliküler, pleksiform ve akantomatoz alt tipleri içeren bir hibrit ameloblastik lezyonu ortaya çıkardı. Sonuç: Hibrit ameloblastoma değişken klinik, radyolojik ve histopatolojik prezentasyona sahiptir. Nadir bir antite olarak, lezyonun biyolojik davranışının daha ileri klinik araştırmalarla kapsamlı bir şekilde analiz edilmesi gerekmektedir. Anahtar Kelimeler: enükleasyon, hibrit ameloblastoma, karnoy

Keywords

• enükleasyon
• hibrit ameloblastoma
• karnoy

References

1. 1. Rai S, Misra D, Prabhat M, Jain A, Jain P. Hybrid ameloblastoma of anterior maxilla: A rare and puzzling pathologic entity–Case report with systematic review. Contemporary Clinical Dentistry. 2019;10(1):147.
2. 2. Wright JM, Tekkesin MS. Odontogenic tumors: where are we in 2017? Journal of Istanbul University Faculty of Dentistry. 2017;51(3 Suppl 1):S10.
3. 3. Waldron CA, El-Mofty SK. A histopathologic study of 116 ameloblastomas with special reference to the desmoplastic variant. Oral surgery, oral medicine, oral pathology. 1987;63(4):441-51.
4. 4. Chaitanya B, Chhaparwal Y, Pai KM, Kudva A, Cariappa K, Acharya S. Hybrid ameloblastoma: An amalgam of rare and conventional ameloblastoma. Contemporary Clinical Dentistry. 2016;7(1):90.
5. 5. Torres-Lagares D, Infante-Cossío P, Hernández-Guisado JM, Gutiérrez-Pérez JL. Mandibular ameloblastoma. A review of the literature and presentation of six cases. Medicina oral, patologia oral y cirugia bucal. 2005;10(3):231-8.
6. 6. Grandis E-NACJ, WHO JTTSP. WHO classification of head and neck tumours. IARC. Lyon; 2017.
7. 7. Santos JNd, De Souza VF, Azevêdo RA, Sarmento VA, Souza LB. " Hybrid" lesion of desmoplastic and conventional ameloblastoma: immunohistochemical aspects. Revista Brasileira de Otorrinolaringologia. 2006;72:709-13.
8. 8. Yamazaki M, Maruyama S, Abé T, Babkair H, Fujita H, Takagi R, et al. Hybrid ameloblastoma and adenomatoid odontogenic tumor: report of a case and review of hybrid variations in the literature. Oral surgery, oral medicine, oral pathology and oral radiology. 2014;118(1):e12-e8.

9. 9. Mladick RA, Robinson L, Martinez M. Unicystic ameloblastoma, a prognostically distinct entity. Plastic and Reconstructive Surgery. 1978;62(3):493.
10. 10. Escande C, Chaine A, Menard P, Ernenwein D, Ghoul S, Bouattour A, et al. A treatment algorythmn for adult ameloblastomas according to the Pitié-Salpêtrière Hospital experience. Journal of Cranio-Maxillofacial Surgery. 2009;37(7):363-9.
11. 11. Kalaskar R, Unawane AS, Kalaskar AR, Pandilwar P. Conservative management of unicystic ameloblastoma in a young child: Report of two cases. Contemporary Clinical Dentistry. 2011;2(4):359-63.
12. 12. Lee P, Samman N, Ng I. Unicystic ameloblastoma—use of Carnoy's solution after enucleation. International journal of oral and maxillofacial surgery. 2004;33(3):263-7.
13. 13. Lau S, Samman N. Recurrence related to treatment modalities of unicystic ameloblastoma: a systematic review. International journal of oral and maxillofacial surgery. 2006;35(8):681-90.