A case report of multiple histological subtypes ameloblastoma with millet-like calcification

Interstitial calcification in Ameloblastoma (AM) with multiple histological subtypes is extremely rare. Notably, no reports exist regarding this feature in unicystic AM. Here, we report a case of a 20-year-old female who presented with a one-month history of chewing pain in the left mandibular posterior region. Cone-beam computed tomography (CBCT) revealed impacted second and third molars in the left mandible. A well-defined cystic lesion surrounded the crowns of these molars, accompanied by partial resorption of the bone plate and areas of bone destruction on the lingual aspect. Multiple millet-like calcifications were observed within the cyst. The lesion involved the root trunk of the first molar but spared the apex. Treatment consisted of curettage and extraction of the impacted teeth. Pathological examination confirmed AM with multiple histological subtypes and interstitial calcification. The Ki-67 proliferation index was approximately 5%. One year post-surgery, the bone structure in the operative area had regenerated well, with no signs of recurrence. This case suggests that AM can present as a mixed form of multiple histological subtypes with millet-like calcifications in the tumor stroma. Routine tumor curettage can yield satisfactory results. This report provides a valuable reference for the diagnosis and treatment of unicystic AM characterized by multiple histological subtypes and millet-like calcification.