Adenoid Ameloblastoma with Dentinoid: A Case Report

Odontogenic tumours are a heterogenous group of lesions that range from hamartomas to benign and malignant neoplasms. 2022 World Health Organisation (WHO) classification classifies benign odontogenic tumours based on their origin from epithelial, ectomesenchymal, or mixed components of odontogenic apparatus. However, there have been isolated case reports and case series of hybrid odontogenic lesions having combined histopathologic features of two or more recognised odontogenic cysts or tumours, affecting the same primary site. These group of lesions are a challenge to pathologists and surgeons, as their histogenesis and clinical behaviour is poorly understood. Adenoid Ameloblastoma with Dentinoid (AAD) is one such variant showing features of both ameloblastoma and Adenomatoid Odontogenic Tumour (AOT) and a high propensity for recurrence. Hereby, the authors present a case of a 36-year-old male who presented with a slow growing right-sided mandibular swelling of five months’ duration. Radiologically, there was a well- defined unilocular radiolucent lesion with smooth margins related to 1st and 2nd premolars and 1st molar. Magnetic Resonance Imaging (MRI) revealed a mixed density mostly cystic lesion involving right mandible. Histologically {Haematoxylin and Eosin (H&E)} the tumour showed hybrid features of ameloblatoma and Adenomatoid Odontogenic Tumour (AOT), with dentinoid formation. Authors report present case owing to the rarity of the lesion, as fewer than 50 cases have been reported in the literature to date.