Granular Cell Ameloblastoma: an Unusual Histological Subtype Report and Review of Literature

BACKGROUND Granular cell ameloblastoma is a rare histological subtype of ameloblastoma accounting for less than 5% of the total. The characteristic microscopic features of granular cells are attributed to the increased presence of lysosomes in the cytoplasm of the tumour cells. METHODS A case of bone expansion in the mandible of 65 year old patient was examined on the basis of the clinical examination, radiographic imaging and microscopic features. A complete surgical removal was performed. RESULTS The radiographic imaging characteristics were consistent with a locally aggressive jaw lesion. Histological examination of the tumour revealed typical features of granular cell ameloblastoma. The specimen margins were free of tumour and the postoperative course was uneventful. No evidence of recurrence was noticed during a 1.5 years follow-up period. CONCLUSIONS The rarity of the granular cell ameloblastoma subtype and the possibility of confusion with other odontogenic and non-odontogenic lesions with a granular cell component require an understanding of the salient features of this locally aggressive neoplasm. A literature review is provided focusing on emerging molecular parameters in the pathogenesis of these tumours and the differential diagnosis of oral lesions featuring granular cells.