Adenoid Ameloblastoma: A New Entity

Abstract

Background
Adenoid ameloblastoma is the new entity added to the odontogenic lesions. The name ‘adenoid ameloblastoma with dentinoid’ was introduced by the Armed Forces Institute of Pathology in 1994 by Brannon. There was no official recognition of this entity as shown in the WHO classification of odontogenic tumors from 1992 to 2017, which can illustrate the diagnostic challenges. It can be considered a hybrid odontogenic tumor showing histopathological features of both ameloblastoma and adenomatoid odontogenic tumor (AOT). The lack of BRAF mutation and the finding of nuclear β catenin reactivity doubt their relation to an ameloblastoma and currently WHO 2022 has identified it as a new entity classified under benign epithelial odontogenic tumors and defined as an epithelial odontogenic neoplasm composed of cribriform architecture and duct-like structures and frequently includes dentinoid.  It usually presents as a painless swelling with prevalent in the 4th decade of life, and with a slight male predilection. The tumor shows more aggressive behavior and high recurrences rate due to a high Ki67 proliferation index.

Case description
Here, we report a case of 35-years-old male who presented with a chief complaint of swelling in the lower anterior region of jaw since 1 month. Intraoral examination revealed localized swelling of 3x2.5 cm in diameter that extended from 33 to 43. Radiographic examination showed mixed radiolucent and radiopaque area.

Conclusion
Clinical and radiographic presentation of adenoid ameloblastoma is not diagnostic and a histopathological examination is necessary not only for confirmation but also for its identification of a new variant.