PMC8235966_01
First visit clinical view shows a localized swelling at the right inferior alveolar process.
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fig1
A 78-year-old patient was first observed in December 2008 at the Complex Operative Unit of Oral Surgery at the Department of Odontostomatological and Maxillofacial Sciences of the "Sapienza" University of Rome due to a small, symptomless, localized swelling at the right inferior alveolar process, between the canine and the first premolar which appeared spaced several millimeters each other (Figure 1).
Orthopantomography at first visit showed a homogeneous, radiolucent, oval-shaped, unilocular area, which appeared quite well-delimited by a peripheral radiopaque and slightly scalloped border.
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fig2
The orthopantomography showed a homogeneous, radiolucent, oval-shaped, unilocular area, well-delimited by a peripheral radiopaque and slightly scalloped border, involving the roots of the canine and the first premolar and vertically oriented, from the top of the alveolar process up to about 1 cm below the apices of the neighboring teeth (Figure 2).
Orthopantomography 1 year after initial treatment: a radiolucent area was detected in the middle of the mineralizing bone tissue.
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Dentascan CT: cross sections detail showed the limited involvement of the lingual cortical bone the limits of the recurrence.
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fig4
Rim resection intraoperative view.
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Histological preparation from the definitive surgically excised tissue, evidence of squamoid area (arrow), H&E x4.
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The tumor cells appear clear with eosinophilic cytoplasm, according to the differentiation H&E x10.
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fig7
H&E x25: mixed type of follicular and acanthomatous solid ameloblastoma.
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Detail from the previous histological preparation. H&E x250: magnification of the acanthomatous component; Malpighian differentiation is highlighted by the presence of desmosomes.
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fig9
Four-year radiographic follow-up. No recurrence was detected.
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