Granular cell ameloblastoma - A rare entity with recurrence after 48 years

Area of Science:

• Oncology
• Oral Pathology
• Surgical Pathology

Background:

• Salivary gland neoplasms can present with diverse clinical and histopathological features.
• Accurate diagnosis is crucial for appropriate management, especially in differentiating benign from malignant conditions.
• Fine-needle aspiration cytology (FNAC) and histopathology play key roles in diagnosing salivary gland tumors.

Observation:

• A 64-year-old female presented with a right preauricular swelling, initially suspected as mucoepidermoid carcinoma or other malignant neoplasm.
• FNAC was inconclusive, necessitating a biopsy for definitive diagnosis.
• Histopathology revealed nests of granular eosinophilic cells and columnar cells, with a history of prior right mandible surgery.

Findings:

• The histopathological findings, combined with the patient's surgical history, led to a diagnosis of granular cell ameloblastoma.
• Radiological evaluation confirmed a solid-cystic lesion in the right masticator space.
• Radical surgery was performed, and the final report confirmed the diagnosis of granular cell ameloblastoma.

Implications:

• This case highlights the importance of integrating clinical history, histopathology, and imaging for diagnosing rare salivary gland tumors.
• Granular cell ameloblastoma, though rare, should be considered in the differential diagnosis of parotid region masses, particularly in patients with a history of jaw surgery.
• Accurate diagnosis and surgical management are essential for favorable outcomes in patients with ameloblastoma.