Under local anesthesia, an incisional biopsy was performed. The area was sutured and the specimen submitted for microscopic evaluation. Based on the biopsy results, the patient was referred to another surgeon for a definitive treatment.

Incisional Biopsy

Histologic examination reveals multiple small pieces of soft tissue composed of a neoplasm of odontogenic epithelial origin surrounded by fibrous connective tissue (Figure 2). The neoplasm is made-up of epithelial islands one shows evidence of a clear cystic configuration (Figure 3). The basal cell layer surrounding the epithelial islands is palisaded. The epithelial layers above the basal cell layer are stellate and squamous epithelium in type exhibiting spongiosis. These islands are surrounded by dense fibrous connective tissue.

Figure 2 Low power (x40) H & E histology illustrates odontogenic epithelial islands surrounded by dense fibrous connective tissue. The larger of the three islands shows evidence of cystic arrangement while the other two are solid with acanthomatous epithelium filling the center.

Figure 3 Higher power (x100) H & E histology illustrates one cystic odontogenic epithelial island with hyperchromatic and palisaded basal cell layer covered by stellate reticulum type epithelium.