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Clinical Report
HUGE AMELOBLASTOMA OF JAW-A CASE REPORT
Subhalakshmi Mukhopadhyay1, Kalpana Raha2, Sambhu Charan Mondal1
ABSTRACT: Ameloblastoma is a tumor of odontogenic epithelium. It is a tumour of intermediate
malignant potential which lies in the gray zone between benign and malignant neoplasm. A huge
ameloblastoma revealing benign cytological features in FNAC is being reported.
Ameloblastoma arises from odontogenic epithelium. This tumor can occur at any age. Though traditionally
divided as solid and cystic, nearly all ameloblastomas show some cystic change. This tumor shows
invasive property and a remarkable tendency of recurrence. The cases showing distant metastasis are
recognized as malignant ameloblastoma. Ameloblastic carcinoma is a tumor with microscopic features
of ameloblastoma that displays malignant features at cytological level. [2] It usually has aggressive course.
A case of large ameloblastoma with slow clinical course and benign cytological as well as histological
features is being reported.
CASE REPORT
A 32-year-old male patient presented with a huge swelling
involving lower jaw which was present for the last 7 years.
The patient was a farmer by profession. The swelling gradually
increased in size making it impossible for the patient to close
his mouth and to articulate properly. Some of the teeth of the
Figure 2: Photograph of the patient after operation.
lower jaw were lost. Mandibular X-ray showed a huge round
radio opaque shadow without any evidence of multilocular
radiolucency. Fine needle aspiraion cytology (FNAC) revealed
dark brown fluid substance. Smears showed low cellularity.
Figure 1: Photograph of the patient showing the tumor. The cells were of benign characteristic, which were discrete,
1
Assistant Professor Department of Pathology R G Kar Medical College Kolkata, 2Associate Professor Department of Pathology R G Kar Medical College
Kolkata
Indian Journal of Otolaryngology and Head and Neck Surgery Vol. 57, No. 3, July-September 2005
247 CMYK

2. 248 Huge ameloblastoma of jaw-A case report
elongated or oval in shape with abundant cytoplasm. Some
osteoblasts were also present in the smear. No giant cells were
detected. A provisional diagnosis of ameloblastoma was made.
The swelling was resected out along with the mandible. [Table
2] The size of the mass was 25 cm. x15 cm.x10 cm. Histology
showed islands of epithelial cells with central loose network
of cells resembling stellate reticulum of ameloblastoma. [Table
3]
DISCUSSION
Diagnosis of ameloblastoma depends upon appropriate
Figure 3: Microphotograph showing epithelial island with squamous
histological findings in proper clinical setting. Radiology often metaplasia. (x40)
helps in preoperative diagnosis. In this case diffuse opacity,
possibly caused by extensive destruction of the mandible and REFERENCES
cystic changes, gave rise to confusion. No specific FNAC 1. Rosai J. Ackerman’s Surgical Pathology. Mosby, 1996;271-2.
finding of ameloblastoma was found in literature review In 2. Slootweg PJ, Muller H. Malignant ameloblastoma or ameloblastic
this case FNAC suggested a benign lesion. Absence of carcinoma. Oral Surg. Oral Med Oral Pathol 1984;57:168-76.
malignant cells was a significant finding in FNAC. Histology
was confirmatory. Such a huge size of a benign ameloblastoma Address for correspondence
is rare in literature. FNAC may play significant role in Dr. Subhalakshmi Mukhopadhyay BB 41/8,Salt Lake City
pre-operative assessment of behavior of such tumor. Kolkata -700064, E mail-sambuddhaghosh@hotmail.com
Clinical Report
FOREIGN BODY IN THE NASOPHARYNX OF A CHILD
Arunabha Sengupta1, Pinaki Saha2, Subhasish Chakrabarty3
ABSTRACT: Introduction of foreign body into the nasal cavity of the children by themselves is very
common, but lodgment of foreign body in the nasopharynx following introduction through mouth is
unusual. Here a case is presented from the Otorhinolaryngology department of S.S.K.M. Hospital, Kolkata,
where a child was brought by their parents with history of introduction of a metallic foreign body in the
mouth of the child by himself and this foreign body was found to be lodged in the nasopharynx of the
child. The foreign body was removed orally in the out patient department. The patient returned home
without any complication.
Key words: Laryngoscope, Luc’s forceps, Nasopharynx
Incidence of foreign body being introduced into the nasal without any complication with advice for oral antibiotic.
cavity of a child by himself or herself is very common, but
lodgment of foreign body in the nasopharynx after CASE REPORT
introduction through mouth is very unusual. Here a case report The child was playing with a thimble (a metallic hollow
is given, where a metallic foreign body after being introduced truncated cone which tailors wear in their index finger during
into the mouth of a child by himself ultimately had get lodged stitching) and suddenly put it into his mouth. When noticed
in the nasopharynx. This was diagnosed clinically and at around 7:30A.M., he was lying down with his mouth open
radiologically. The foreign body was removed in the out and crying. His parents tried to bring it out by putting their
patient department orally and the patient was sent home fingers in his mouth but could not localize the foreign body.
1
Assistant Professor, 2Junior Resident, 3Junior Resident, Department of Otorhinolaryngology, S.S.K.M. Hospital and I.P.G.M.E. & R., Kolkata
Indian Journal of Otolaryngology and Head and Neck Surgery Vol. 57, No. 3, July - September 2005
248 CMYK