Large mandibular mass with several floating teeth: granular cell ameloblastoma

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.