A rare case report of acanthomatous ameloblastoma based on aspiration cytology with histopathological confirmation

Abstract

Ameloblastoma is a benign progressively growing intraosseous epithelial odontogenic tumor. It is characterized by expansion and a tendency for a local recurrence if inadequately removed. Since it has an aggressive clinical course, surgical removal and histopathological examination should be done for appropriate management. In this case study, a 52-year-old female patient came to our institute with a complaint of swelling in the lower midline of gum. The patient has a history of bleeding gum and swelling 25 years back, for that she underwent tooth extraction in a private clinic. The patient again developed gum swelling year back, for that she underwent tooth extraction in a private clinic. However, this time her symptoms persisted, and for this reason, the patient visited our institute. On palpation, the lesion was firm and non-tender, appeared to arise from mandibular bone. Magnetic resonance imaging (multiplanar and multisequence) was done and it was reported as expansile multiseptate mandibular symphysis mass, possibly ameloblastoma. FNAC was done from the right lower alveolus in a private pathology laboratory, which was reported as pleomorphic adenoma with focal squamous metaplasia. These slides were reviewed in our institute and we reported it as suggestive of odontogenic tumor, favoring ameloblastoma. Biopsy and histopathological examination was advised for confirmation. Tumor was surgically enucleated along with curettage of the site and excised specimen was sent for histopathological examination to the pathology department of our institute. Based on the clinical, radiological, cytological, and histopathological examination, a final diagnosis of acanthomatous ameloblastoma was made. To the best of our knowledge, very few cases of acanthomatous type of ameloblastomas have been diagnosed on aspiration cytology followed by excision and histopathological confirmation. In this case study, we tried to highlight the importance of early diagnosis by cytology which helps in early treatment by surgical excision of this locally aggressive tumor.