Desmoplastic ameloblastoma: correlative histopathology, radiology and CT‐MR imaging

Abstract

A desmoplastic variant of ameloblastoma with osteoplasia in the stroma is reported. This tumour presented in the canine/premolar region of the left maxilla of a 31-year-old woman. It was treated by partial hemimaxillectomy and immediate reconstruction with a non-vascularised iliac graft. The location of this lesion, its histology and radiological features differ from those of the conventional ameloblastoma. The behaviour and prognosis of the desmoplastic ameloblastoma (DA) cannot at this stage be predicted due to the small number of cases that have been reported and a lack of long-term follow-up. To our knowledge this is the first documentation of the CT and MRI features of desmoplastic ameloblastoma with pathologic correlation.

Proliferating cell nuclear antigen (PCNA) and p53 protein expression in ameloblastoma and adenomatoid adontogenic tumor

“…Studies (1,14) have postulated that there is no correlation between the histologic types of ameloblastomas and the clinical behavior (and consequent prognosis) of these lesions because more than one cellular configuration can be seen in a single lesion. On the other hand, Ueno et al (15) stated that it is possible to establish a correlation between both the patient's age and the radiographic/ histologic aspects of a tumor and its clinical behavior.…”

Desmoplastic ameloblastoma: a case report

“…High resolution bone algorhithm computed tomography images, however, reflect the invasion of tumor elements between peripherally situated bone trabeculae where resorption due to tumor expansion and the deposition of new bone around these resorbed trabeculae has occurred. 14 …”

Desmoplasic Ameloblastoma in Maxilla: Report of Case and Review of the Literature

“…The differential diagnosis according to the radiographic aspects include fiberosseous lesions, fiber dysplasia, chronic osteomyelitis and ossifying fibroma (Iida et al) The histopathological characteristics described for this case are in accordance to the diagnosis criteria established for the desmoplasic ameloblastoma according to Kishino et al This way, such lesion is characterized by small nests and cords of odontogenic tumoral epithelium, organized in an abundant stroma densely collagenized, which makes these tumoral islands seem like they are comprised (Dos Santos et al, Hirota et al) The peripheral cells can lose, sometimes, those morphologic characteristics similar to the ameloblastomas such as the polarity inversion. In addition to this, the central portion of the tumoral islands can present loosely organized cells resembling the stellate reticulum of the enamel organ, with occasional squamous metaplasia and central focuses of keratination (Takata et al) In the desmoplasic variation, usually, there can be verified an osseous neo-formation that according to Thompson et al(1996), represents an attempt to fix the damages caused by the osseous reabsorption caused by the tumoral expansion. In the case above, such osseous formations were not evidenced in the epithelial proliferation.…”