Desmoplastic ameloblastoma of the mandible.

The Authors present a rare case of Desmoplastic Ameloblastoma (DA) involving the jaw. The desmoplastic ameloblastoma (Eversole et all. was the first to describe 3 cases in 1984), is an "hybrid" variant of ameloblastoma in which histologically coexist areas of follicular or plexiform ameloblastoma exhibiting dense collagenus desmoplastic stroma. This variant is always found in 3th to 5th decade of life with a prevalence in the males. In our cases, the patient presented a swelling at the level of 3.4-3.5 with erosion of the mandibule's vestibular cortical, without others clinical signs; OPT and CT dentalscan showed a lesion of cystic aspect, localized at the level of the left mandible. In loco-regional anaesthesia and the block excision was performed. Histologic analysis revealed islands of epithelium, disperse in a dense collagenous stroma with peripheral palisading of elongated cells with reverse polarity. The clinical and strumental (OPT) follow-up at one and two years disclosed residual tumour and recurrence. The lesion often have not a capsule and the cells infiltrate into surrounding bone trabaculae with an xtension of same mm beyond the radiographic margin. Consequently it's necessary a complete resection of the lesion with an excision of 10mm of bone beyond the radiographic sign to ensure the negative margins. The courrettage is not indicated. The biological behaviour of DA is still not fully understood because there are few cases reported in literature with an insufficient follow-up.