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CPC 11
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A 23 year old man presented to the emergency room of a hospital complaining of an altered bite and left facial pain. He had sustained a blow to the left side of the face several hours earlier. The past medical history was negative, but dental history was significant for extraction of the lower left third molar three years ago. At that time, the patient was informed that a small cyst also had been removed, however, no tissue had been submitted for histopathologic examination. The radiograph reveals a large unicystic radiolucency and a fracture of the ascending ramus.

Differential Diagnosis:

  1. Ameloblastoma
  2. Odontogenic Keratocyst
  3. Residual dentigerous cyst

Note: Exclude those lesions which are usually multilocular, e.g. odontogenic myxoma.


Slide 1 (medium power, H&E). There are islands of epithelial cells contained within a fairly mature connective tissue stroma. The periphery of the tumor islands are composed of columnar cells with uniform tall nuclei. Centrally, the islands contain a somewhat edematous collection of cells reminiscent of stellate reticulum.

Diagnosis: Ameloblastoma