A rare presentation of hybrid odontogenic tumor involving calcifying cystic odontogenic tumor and plexiform ameloblastoma
A 17-year-old male patient reported with a presenting complaint of swelling in the lower part of face on the side since 1 month. The swelling was initially small in size and gradually kept increasing. The increase in the size of swelling was associated with tooth mobility in the mandibular right quadrant. The swelling was not associated with any episode of pain or paresthesia and could not be linked to any history of previous trauma or dental infection. Patient visited a private practitioner to seek treatment, but instead was referred to out-patient department.\nOn extraoral examination, a diffuse swelling was evident in the chin region on the right side extending to the mandibular body to some extent []. The swelling was painless and soft to firm on palpation. Lymph node examination revealed palpable single right submandibular lymph node which was firm and non-tender.\nIntraoral examination [] revealed diffuse swelling with 41, 42, 43 region involving both labial and lingual aspect of size around 1.5 cm × 1 cm each, which was soft to firm and non-tender on palpation. Radiographic diagnosis [Figures and ] revealed a large ill-defined, non-corticated interradicular radiolucent lesion with 43 and 42 region causing pathologic drifting and external root resorption of 42, 41, 31. An important finding was evidence of a small focus of calcification near the periapical region of 41.\nUnder the clinic-radiographic diagnosis of calcifying epithelial odontogenic cyst, patient was advised for aspirational biopsy, which yielded clear fluid. The lesion was enucleated along with the involved teeth, viz. 43, 42, 41, 31. The histopathological examination of the specimen showed a cystic cavity lined with tall, columnar odontogenic cells along with the presence of ghost cell keratinization and basophilic material with cystic cavity lined by tall columnar odontogenic cells, which is suggestive of CCOT associated with plexiform ameloblastoma []. The patient has been followed-up for 6th month until date and shows no signs of recurrence.