Desmoplastic ameloblastoma mimicking a periapical lesion
Keywords:Desmoplastic ameloblastoma, odontogenic tumor, periapical lesion
AbstractPurpose: Desmoplastic Ameloblastoma (DA) is a rare variant of ameloblastoma, with specific clinical, imaginological and histopathological features. The biologic profile of this tumor is not fully understood because of the limited number of reported cases. The purpose of this paper is to report a case of DA mimicking a periapical lesion. Case Description: This tumour appeared in the anterior region of the left upper jaw of a 24-year-old female, between left lateral incisor and canine. The lesion was painless and only a slight swelling of the hard palate mucosa was noted. Radiographically, a well-delimited peak-like radiolucent area promoting root divergence was observed. The lateral incisor failed in responding positively to the pulp tests. Provisional diagnosis of radicular cyst versus fissural cyst was established and surgical enucleation followed by curettage was carried out. Histological examination of the specimens revealed proliferation of nests and cords of compressed odontogenic epithelium immersed in a densely collagenized stroma, associated to a few irregular bone trabeculae. Conclusion: These features were consistent with DA. The presence of a pulpally necrotic incisor and the atypical radiographic appearance obscured the disease. Despite the high rates of recurrence, no clinical or radiographic sign of reincidence of the tumor was detected one year later.
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