case_images: PMC7395988_01
case_images: Orthopantomograph showing the presence of an ill-defined, mixed radiolucent-radiopaque lesion involving the #84 to #85 region. Bone and roots resorption can be observed (red arrow).
case_images: CRID2020-4072890.001.jpg
case_images: PMC7395988_01_CRID2020-4072890.001.jpg
case_images: fig1
case_images: The lamina dura, roots of #84 and #85, and furcation of #84 were resorbed (Figure 1).
case_images: CT images showing a lesion with bony cortex perforation (red arrow, (a) and (b)) and soft tissue infiltration and lymph nodes involvement (red arrow, (c) and (d)).
case_images: CRID2020-4072890.002.jpg
case_images: PMC7395988_01_CRID2020-4072890.002.jpg
case_images: fig2
case_images: The lingual cortex was partially damaged (Figure 2).
case_images: Photomicrographs showing sheets and nests of ameloblastic epithelium with inflammatory infiltration ((a) hematoxylin eosin); areas of tumor cells with hyperchromatism, nuclei pleomorphism, and some mitotic figures ((b) hematoxylin eosin); marked positive immunohistochemical expression of CK19 (c), Ki67 (d), and p53 (e).
case_images: CRID2020-4072890.003.jpg
case_images: PMC7395988_01_CRID2020-4072890.003.jpg
case_images: fig3
case_images: The peripheral cells of the nests resembled preameloblasts with cuboid shape and nuclei polarization (Figure 3(a)). Dedifferentiated areas exhibited cytologic malignant cells with increased nucleocytoplasmic ratio and hyperchromatic nuclei; few mitotic figures were present (Figure 3(b)). The ameloblastic epithelium showed a positive reactivity for CK19 (Figure 3(c)). High proliferation level of the neoplasm was confirmed by elevated expression of Ki67 and p53 (Figures 3(d) and 3(e)).
case_images: Photomicrographs showing tumor infiltration in the submandibular lymph node: dedifferentiated area with infiltrated neoplastic cells ((a) hematoxylin eosin); higher power view of the infiltrated lymph node showing nuclear pleomorphism and hyperchromatism of the neoplastic cells ((b) hematoxylin eosin).
case_images: CRID2020-4072890.004.jpg
case_images: PMC7395988_01_CRID2020-4072890.004.jpg
case_images: fig4
case_images: The positive submandibular lymph nodes were identified, and the microscopic examination of the lymph nodes showed diffuse infiltration of neoplastic cells (Figure 4).
case_images: Photographs of the patient at 2-year postoperation.
case_images: CRID2020-4072890.005.jpg
case_images: PMC7395988_01_CRID2020-4072890.005.jpg
case_images: fig5
case_images: Clinical and radiographic examination at 2 years postoperatively showed no sign of recurrence or metastasis (Figure 5).