case_images: PMC3591079_01
case_images: Orthopantomogram of the patient; asterix indicates the extent and nature of the radioluceny in between the apices of the right maxillary canine and lateral incisor. Inset shows the periapical radiograph of the area
case_images: AMS-2-82-g001.jpg
case_images: PMC3591079_01_AMS-2-82-g001.jpg
case_images: F1
case_images: Routine panoramic examination revealed a radiolucent lesion in the right anterior region, measuring 1.7 cm x 1.4 cm [Figure 1]. Closer radiological examination with periapical radiography revealed that the maxillary right canine root was in juxtaposition with the entity while the lateral incisor had a loss of lamina dura [Figure 1].
case_images: The lesional area after raising the semilunar flap. Note the shape of the lesion and bone overlying the cyst
case_images: AMS-2-82-g002.jpg
case_images: PMC3591079_01_AMS-2-82-g002.jpg
case_images: F2
case_images: On elevating a wide, semilunar flap, a well-circumscribed area of elevated, thinned cortex was identified [Figure 2].
case_images: Total removal of the cystic content in toto
case_images: AMS-2-82-g003.jpg
case_images: PMC3591079_01_AMS-2-82-g003.jpg
case_images: F3
case_images: Carefully, the margins were explored and the entire lesion was removed in total after careful blunt dissection [Figure 3].
case_images: Composite image of A. The residual bone with healthy bleeding after removal of the cyst B. Buccal surface of the cyst C. Lingual surface of the lesion
case_images: AMS-2-82-g004.jpg
case_images: PMC3591079_01_AMS-2-82-g004.jpg
case_images: F4
case_images: The residual bone was clear with no evidence of cystic lining [Figure 4A]. The macroscopic appearance was nonspecific, except for the prominent superficial vasculature [Figure 4B and C].
case_images: A) The area showing thin OE with basal cells resembling ameloblasts, ghost cells, and extravasated red blood cells. (H and E section, 20x) B) A foci showing the thickened lining with palisaded basal cells resembling ameloblasts, ghost cells, and extravasated red blood cells. (H and E section, 10x) C) A foci showing thickened lining with palisaded basal cells resembling ameloblasts, ghost cells, superficial stellate reticulum-like cells, and extravasated red blood cells. (H and E section, 40x)
case_images: AMS-2-82-g005.jpg
case_images: PMC3591079_01_AMS-2-82-g005.jpg
case_images: F5
case_images: A few of them contained nuclear remnants [Figure 5].
case_images: A) Foci showing arrangement of solid areas of odontogenic cells near cystic lumen with cords and lattice pattern, indicative of AOT features (H and E section, 4x) B) Foci showing areas of cholesterol clefts in an uninfected area. C) Foci showing features suggestive of AOT. Note the ductal or rosette-like appearance, reversal of polarity, centrally placed atypical material that has varying pattern (asterix), prominent intercellular bridges, and duplicated basal membrane in certain areas. (H and E section, 20x)
case_images: AMS-2-82-g006.jpg
case_images: PMC3591079_01_AMS-2-82-g006.jpg
case_images: F6
case_images: Toward the center of the lesion, in this area, arrangement of ameloblast-like cells in the form of ductal or rosette pattern was observed [Figure 6]. Also in one particular foci, cholesterol clefts were identified [Figure 6B].