Incisional and Excisional Biopsy

The histology revealed a fragment of a cystic structure, a benign neoplasm of odontogenic origin and tooth-like structures. The cystic structure comprised a small portion of the specimen and was consistent with a dentigerous cyst. The benign soft tissue neoplasm comprised the bulk of the specimen and was composed of mixed epithelial and connective tissue components (Fig 3). The epithelial component was made up of small clusters, cords, and islands while the connective tissue ranged from myxoid and primitive to collagenous and hyalinized. The latter was predominant. Also present were clusters of calcified material (Fig 4), most of which were dysplastic in nature. The combination of the microscopic and gross multiple tooth-like structures were diagnostic features of an ameloblastic fibro-odontoma.

Figure 3.  Low power (x200) histology shows dense fibrous connective tissue background with small nests of odontogenic epithelial islands. Some of the islands are lined by a layer of palisaded columnar epithelial cells.

Figure 4. Low power (x100) histology shows clusters of calcified material.