International Journal of Scientific Research in Dental and Medical Sciences

International Journal of Scientific Research in Dental and Medical Sciences

Granular Cell Transformation in Plexiform Ameloblastoma: Case Report and Literature Review

Document Type : Case Reports

Authors
Aravindan S 1
Nikita Kashyap 2
Saharsh Sarawgi 1
Sudipta Rakshit 1
Srihari S 1
Suchitra Kisku 1
1 Department of Oral and Maxillofacial Pathology, Dr. R. Ahmed Dental College & Hospital, Kolkata, India
2 Department of Oral and Maxillofacial Pathology, Post Graduate Institute of Dental Sciences, Rohtak, India
10.30485/ijsrdms.2025.508673.1641
Abstract
Ameloblastoma is the most common odontogenic tumor, primarily occurring in the posterior mandible. It is a slow-growing yet locally invasive epithelial tumor that generally follows a benign course. Granular cell ameloblastoma is a rare variant differentiated by the nests of large eosinophilic granular cells resulting from cytoplasmic transformation. This variant is considered to be more aggressive than any other variant. We report a rare case of plexiform ameloblastoma with granular cell transformation in a 50-year-old male patient presenting as a painless swelling on the right side of the body of the mandible. While granular cell ameloblastoma transformation is well documented in follicular ameloblastoma, its presence in the plexiform variant is extremely rare. This case expands the histologic spectrum of ameloblastoma and underscores the importance of recognizing such variations to avoid diagnostic confusion. Additionally, we re-evaluate the widely held belief regarding its aggressiveness, highlighting emerging evidence that challenges its traditionally aggressive nature. The patient underwent surgical excision in December 2024 and remains under early postoperative follow-up, with long-term monitoring planned to assess recurrence and progression.
Keywords
Ameloblastoma
Granular Cell Tumor
Lysosomes
Odontogenic Tumors
Plexiform

Subjects

[1] Rattanakuntee S, Thosaporn W, Ketchaikosol N, Imerb N. Granular cell ameloblastoma in maxilla: A report of rare case. Oral and Maxillofacial Surgery Cases. 2023;9(2):100299. https://doi.org/10.1016/j.omsc.2023.100299.
[2] Suchitra G, Harshaminder G, Kunal S. Granular cell ameloblastoma showing desmoplasia. Annals of Saudi Medicine. 2012; 32 (5): 537-540.
[3] Khan SJ, Gawande M, Hande A, Patil S, Sonone A. Granular Cell Ameloblastoma: A Rare Case Report and Literature Review. Journal of Clinical & Diagnostic Research. 2023 Feb 1;17(2). https://doi.org/10.7860/JCDR/2023/61118.17500.
[4] Sukumaran R, Somanathan T, Sen A. Granular cell ameloblastoma: A rare and unique variant. Indian Journal of Case Reports. 2022;8(11):360-2. https://doi.org/10.32677/ijcr.v8i11.3359.
[5] Motahhary P, Etebarian A, Asareh F. Granular cell type of a unicystic ameloblastoma: an unusual case and review of the literature. Journal of Oral and Maxillofacial Pathology. 2014;18(2):331. https://doi.org10.4103/0973-029X.140927.
[6] Soluk-Tekkesin M, Wright JM. The World Health Organization classification of odontogenic lesions: a summary of the changes of the 2022 (5th) edition. Turkish Journal of Pathology. 2022;38(2):168-84. https://doi.org/10.5146/tjpath.2022.01573.
[7] Bhat SS, Chatra L, Shenoy P, Veena KM, Prabhu R, Buch S. Granular Ameloblastoma a Case Report. International Journal of Research and Reports in Dentistry. 2021;4(3):7-12.
[8] WHO Classification of Tumours. Head and Neck Tumours. 5th ed. Lyon: IARC, 2024;9.
[9] Yamunadevi A, Madhushankari GS, Selvamani M, Basandi PS, Yoithapprabhunath TR, Ganapathy N. Granularity in granular cell ameloblastoma. Journal of Pharmacy and Bioallied Sciences. 2014;6(Suppl 1):S16-20. https://doi.org/10.4103/0975-7406.137253.
[10] Nikitakis NG, Tzerbos F, Triantafyllou K, Papadimas C, Sklavounou A. Granular cell ameloblastoma: an unusual histological subtype report and review of literature. Journal of oral & maxillofacial research. 2011;1(4):e3. https://doi.org/10.5037/jomr.2010.1403.
[11] Arora S, Mujhib A, Diwakar G, Amberker V. Granular cell ameloblastoma: A case report with a brief note on review of literature. Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 2014;15(3):267-9. https://doi.org/10.1016/j.ejenta.2014.06.002.
[12] Martin Y, Sathyakumar M, Premkumar J, Magesh KT. Granular cell ameloblastoma. Journal of Oral and Maxillofacial Pathology. 2017;21(1):183. https://doi.org/10.4103/jomfp.JOMFP_45_15.
[13] Kulkarni D, Ingale Y, Ingale M, Ajabrao BN, Mayank M, Kulkarni A. Granular cell ameloblastoma: A rare case report and review of literature. Indian Journal of Dental Research. 2018;29(6):830-5. https://doi.org/10.4103/ijdr.IJDR_407_17.
[14] Reddy V, Bansal V, Wadhwan V, Venkatesh A. Granular cell Ameloblastoma of the mandible–A rare case report with brief review of literature. Subharti Journal Of Interdisciplinary Research. 2018;1(1):13-7.
[15] Jahanshahi G, Arzhang E, Derisavy S, Davoodi L, Shakeri S. Granular cell type of ameloblastoma. Dental research journal. 2018;15(3):224-7.
[16] Cadavid AM, Teshima TH, Pinto CA, Camillo CM, Lourenço SV. Ameloblastoma with distinctive granular cell pattern: an 8 case study. Autopsy & Case Reports. 2018;8(4):e2018052. https://doi.org/10.4322/acr.2018.052.
[17] Mathew A. A case report on granular cell ameloblastoma–A rare histological entity. Indian Journal of Radiology and Imaging. 2020;30(02):225-8. https://doi.org/10.4103/ijri.IJRI_145_19.
[18] Banerjee A, Wati SM, Das M, Srivastava KC, Shrivastava D, Ronsivalle V, et al. Aggressive granular cell ameloblastoma arising from radicular cyst: a case report of an unusual variant and a public health concern. Journal of Public Health and Emergency. 2024;8:10. https://doi.org/10.21037/jphe-23-114.
[19] Babu NA, Sridharan R, Rajesh E, Malathi L. Granular Cell Ameloblastoma: A Rare Threat Requiring Vigilance and Lifelong Follow-Up. Journal of Pharmacy and Bioallied Sciences. 2024;16(Suppl 5):S4932-4. https://doi.org/10.4103/jpbs.jpbs_1294_24.
[20] Kumamoto H, Ooya K. Immunohistochemical and ultrastructural investigation of apoptotic cell death in granular cell ameloblastoma. Journal of oral pathology & medicine. 2001;30(4):245-50. https://doi.org/10.1034/j.1600-0714.2001.300409.x.
[21] Ara Sathi GS, Han PP, Tamamura R, Nagatsuka H, Hu H, Katase N, et al. Immunolocalization of cell signaling molecules in the granular cell ameloblastoma. Journal of oral pathology & medicine. 2007;36(10):609-14. https://doi.org/10.1111/j.1600-0714.2007.00580.x.
[22] Kumamoto H, Kimi K, Ooya K. Immunohistochemical analysis of apoptosis‐related factors (Fas, Fas ligand, caspase‐3 and single‐stranded DNA) in ameloblastomas. Journal of oral pathology & medicine. 2001;30(10):596-602. https://doi.org/10.1034/j.1600-0714.2001.301004.x.
[23] Kumamoto H, Ohki K, Ooya K. Expression of p63 and p73 in ameloblastomas. Journal of oral pathology & medicine. 2005;34(4):220-6. https://doi.org/10.1111/j.1600-0714.2005.00284.x.
International Journal of Scientific Research in Dental and Medical Sciences
Volume 7, Issue 1
Winter 2025
Pages 35-39

  • Receive Date 25 January 2025
  • Revise Date 26 February 2025
  • Accept Date 02 March 2025
  • Publish Date 04 March 2025