Multifarious Histological Patterns in Solid Multicystic Ameloblastoma : A Rare Presentation

The jaws are host to a wide variety of cysts and tumors, contributed largely by the tissues involved in tooth formation. Ameloblastoma, the second most common odontogenic tumor is usually a benign, locally aggressive neoplasm of enamel organ type tissue, which does not undergo differentiation to the point of enamel formation. It commonly manifests as a slow-growing, locally invasive neoplasm, located intraosseously showing few or no clinical signs in early stages which may gradually result in facial deformity, loose teeth, pathological fracture, and pain due to secondary infection or impingement on peripheral nerves. This tumor shows a male predilection and mandible (ramus area) is affected more commonly than the maxilla. These tumors also tend to show wide morphological variations. We report a case of solid multicystic ameloblastoma (SMA) in a 27-year-old male patient who presented with the complaint of pain and a slow growing swelling in the lower right posterior region of the jaw since 3 months. Hemimandibulectomy was done and the resected specimen, when subjected to histopathological examination, confirmed the diagnosis of SMA showing a mix of histological patterns comprising of follicular, plexiform along with the uncommon granular type. This case report also reviews various mixed histopathologic patterns seen in SMA.