Pigmented ameloblastic fibrodentinoma: a novel melanin-pigmented intraosseous odontogenic lesion

This paper reports about an ameloblastic fibrodentinoma with macroscopically visible pigmentation, resulting in the clinical appearance of a melanotic lesion in a 21-year-old Japanese male. In addition to the characteristic histopathologic features of ameloblastic fibrodentinoma, various-formed and -sized cells, which were considered to be melanophages containing numerous aggregates of melanin pigment in their cytoplasm, were densely distributed throughout the mesenchymal component. In addition, melanin pigment was deposited in dentin. Some of the pigmented cells showed dendritic form and were regarded as melanocytes. Furthermore, pigmented cells were frequently distributed in the epithelial component, and melanin pigment was seen in some epithelial cells. Perusal of the English language literature revealed 30 cases of pigmented odontogenic tumors: 18 were calcifying odontogenic cysts, three were ameloblastic fibro-odontomas, three were adenomatoid odontogenic tumors, two were odontomas, one was an ameloblastic fibroma and one was an odontogenic fibroma. However, all of these reported lesions did not show macroscopically visible pigmentation. The possible histogenesis of melanocytes in the odontogenic lesions is discussed, although no firm conclusion could be drawn.