CONVENTIONAL AMELOBLASTOMA, BEYOND A CLINICAL AND RADIOGRAPHIC ANALYSIS: A HISTOLOGICAL REVIEW OF ITS VARIANTS

Abstract

Ameloblastoma is a tumor of odontogenic origin that arises from remnants of the dental lamina. Conventional ameloblastoma is the most common subtype of ameloblastoma. It primarily occurs in adult patients, affecting the posterior region of the mandible more frequently. Generally, the tumor is asymptomatic and slow-growing. Radiologically, it presents as a radiolucent/hypodense image with well-defined and scalloped borders, either unilocular or multilocular. When multilocular, it may exhibit small locules, referred to as "honeycomb," or larger locules resembling "soap bubbles." Histologically, six subtypes can be identified: follicular, plexiform, acanthomatous, desmoplastic, granular cell, and basal cell ameloblastoma. This study aims to conduct a literature review of the histological variants of conventional ameloblastoma. The present study is characterized as a documentary, retrospective, and applied research of the narrative literature review type. The selected database for this research was PubMed. The search terms used as descriptors were "Ameloblastoma", "histological" and "variants." A total of 962 articles were retrieved, and after applying a time frame filter of five years (2020-2025), 253 articles were listed. Articles unrelated to the topic, without full text, and those including theses and dissertations were excluded. In the end, 10 articles were used for this study. The results indicate that the main pattern found is the follicular type, characterized by the formation of nests of epithelial cells within the tumor stroma. The plexiform pattern shares similar characteristics but presents epithelial cords within the connective tissue. The acanthomatous pattern displays keratin pearls within its connective tissue, while the granular cell pattern shows the presence of cells with eosinophilic cytoplasm and nuclei displaced towards the periphery. The desmoplastic pattern is marked by scarce odontogenic epithelium and a more fibrous stroma. Finally, the basal cell pattern presents ameloblastic epithelium with more eosinophilic columnar cells along with the presence of blood vessels in its stroma. This study highlights a significant diversity in the histological presentations of conventional ameloblastoma, suggesting that these differences may influence both diagnosis and therapeutic strategies. Understanding these histological variants of conventional ameloblastoma is essential for a better comprehension of the clinical behavior of the lesion, as well as treatment modalities and prognosis.