Ameloblastomas are benign, locally aggressive, odontogenic epithelial neoplasms. We present a patient with a rare granular cell ameloblastoma. This is a case report and literature review conducted from July 2022 to the present. Our 52-year-old male patient presented to the clinic with a several month history of right lower lateral lip swelling and dental complaints. On imaging and physical exam, we noticed a large heterogenous, multiloculated, expansile lesion of the right mandible with several floating teeth. After incisional biopsy confirmed multicystic granular cell ameloblastoma, the patient underwent successful surgical resection and osteocutaneous fibula free-flap reconstruction. At the time of writing this report, 7 years after resection, the patient is alive with no evidence of recurrence. The recognition and treatment of mandibular lesions can represent significant clinical challenges, especially for rarely seen subtypes such as the granular cell ameloblastoma. Special consideration must be given for the identification and treatment of these neoplasms.

The ameloblastoma is a slowly growing, locally invasive, benign epithelial odontogenic neoplasm of the jaws with a high rate of recurrence if not removed adequately. We report an interesting case of granular cell ameloblastoma, which presented as a solitary, peripheral, soft tissue growth 20 years after initial segmental resection of the left mandible. The basal layer of oral mucosa could be the possible source of peripheral ameloblastoma in our case. In order to reduce the chances of recurrence, we suggest to incorporate mucosal stripping along with the conventional treatment as a mandatory rather than an elective procedure while treating ameloblastoma.

A 64-year-old female with complaints of swelling right preauricular region was referred to our tertiary cancer center with fine-needle aspiration cytology (FNAC) report of mucoepidermoid carcinoma and radiological differential of malignant salivary gland neoplasm and sarcoma. On examination, there was a mass over her right parotid region Clinical diagnosis was malignant salivary gland neoplasm. Slide review of FNAC was inconclusive. Biopsy was done. Histopathology showed neoplasm comprising of nests of cells with abundant granular eosinophilic cytoplasm with focal area showing peripherally arranged columnar cells with palisading. On enquiry, the patient gave a history of surgery of right mandible 48 years back. Correlating histopathology and clinical history, a diagnosis of granular cell ameloblastoma was rendered. Radiological evaluation showed a solid-cystic lesion in the right masticator space. Right mandible showed only part of head of mandible consistent with previous surgery. Radical surgery was done. Final report confirmed the biopsy diagnosis.

Squamous odontogenic tumor (SOT) is a rare benign neoplasm and may be located to multiple sites in the oral cavity mouth. As per the literature, there have been <50 reported cases. The tumor is often asymptomatic, although it can present with symptoms of pain and tooth mobility. Peripheral odontogenic tumor is a rare entity derived from either epithelial or mesenchymal portions of the tooth-forming apparatus. Lesions are common to gingiva and alveolar mucosa. Peripheral granular cell ameloblastoma (GCA) is considered to be even rarer. The purpose of the study is to report a case of SOT with a synchronous association with peripheral GCA of cystic nature in the mandible. The occurrence of SOT with ameloblastoma has not been reported as per the literature search.

Ameloblastomas can present in various clinical and histomorphologic patterns. The granular cell variant accounts for only 3.5% to 5% of ameloblastomas. The aim of this case report is to present an example of ameloblastoma with unusual granular cell component, affecting a 63-year-old woman, in which both the inner and peripheral layers of follicles composed exclusively by eosinophilic granular cells. Assessment of the immunohistochemical and histochemical profile of the lesion was performed and the challenges of such a diagnosis were also addressed.

Granular cell ameloblastoma (GCA) is one of the rare histological variants of ameloblastoma (1.5-3.5%), identified by Krompechner in 1918 and is diagnosed by the characteristic presence of granular cells. These granular cells are seen in several physiological and pathological conditions and the granularity in GCA is due to lysosomal aggregates. This review is about the clinical features, histopathological features and differential diagnosis of GCA and also adds the theories for occurrence of granularity, electron microscopic findings, cell signaling pathways and immunohistochemistry findings related to these granular cells in GCA.

An unusual granular variant of ameloblastoma presenting as a mandibular mass in a 43-year-old woman is described. These visually striking tumors display unusual and inconsistent immunohistochemical staining patterns although differential diagnosis from other granular cell lesions of the head and neck is usually not problematic.

Ameloblastoma is an epithelial odontogenic tumour of the jaw and exhibits diverse microscopic patterns which occurs either singly or in combination with other patterns. Peripheral ameloblastoma is a rare odontogenic soft tissue tumor, derived from epithelial and/or mesenchymal elements being part of the tooth-forming apparatus. The lesions responsible for approximately 1% to 5% of all cases of ameloblastoma affecting alveolar mucosa and gingiva occurring mainly, in the middle age. This article describes a case of peripheral ameloblastoma affecting a 35-year-old female. The lesion was located in the right buccal space. The occurrence and pathogenesis of peripheral ameloblastomas in general, are reviewed. The tumour was excised and no recurrence has been observed after twenty four months of surgery.