PMC5824509_01
Intraoral view showing a 3 cm x 2 cm enlargement in the maxilla
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F1
There was no apparent change in color of the overlying mucosa [Figure 1].
Sagittal computed tomography scan revealing a well-delineated isodense mass with thinning of the buccal cortical plate and slight palatal expansion
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F2
Also noted was diversion and resorption of the roots of the incisors [Figure 2].
Photomicrographs of histology (a) Stroma showing delicate collagen fibers disposed in a myxoid matrix with focal distribution of neural elements, rests of odontogenic epithelium with areas of calcification and mast cells (H&E, x4), (b) Focal distribution of neural elements in the connective tissue (H&E, x10); (c) Rests of odontogenic epithelium with areas of calcification (H&E, x20); (d) Stroma showing the presence of numerous mast cells (H&E, x20); (e) Confirmation of mast cells with special stain (Toluidine blue, x20); (f) Strong positive expression of mast cells and fibroblasts for C-kit (Anti C-kit, x20)
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F3
Microscopically, the connective tissue stroma showed delicate collagen fibers disposed in a myxoid matrix containing stellate-shaped fibroblasts [Figure 3a]. A few nerve fibers and dilated blood vessels engorged with red blood cells were seen in the connective tissue [Figure 3b]. At places, a few odontogenic epithelial rests and foci of calcification were present [Figure 3c]. Distributed throughout the stroma were abundant mast cells [Figure 3d], and toluidine blue staining was performed for confirmation of the mast cells [Figure 3e].