A case report of Mixed-Pattern Ameloblastoma with millet-like Calcification

Background : The cases of interstitial calcification in mixed-pattern ameloblastoma (AM) are extremely rare, especially, there have been no reports on this type of single-cyst AM cases. This case was analyzed through imaging, pathological data and postoperative follow-up, combined with relevant literature, to provide guidance for the clinical diagnosis and treatment of this type of AM. Case presentation: A 20-year-old female patient presented with the second and third molars in the left mandible not visible on oral examination. Cone beam computer tomography (CBCT) examination showed that the left mandibular second molar was vertically impacted in a low position, while the third molar was horizontally impacted with a forward inclination. A cystic low-density shadow surrounded the crown, and there was partial resorption of the bone plate. Bone destruction areas were visible on the lingual bone plate. Multiple millet-like calcifications were observed within the root tip. The lesion involved the root body of the first molar but did not affect the apex. Treatment involved curettage and extraction of the impacted teeth, and the pathological diagnosis was mixed-pattern AM with interstitial calcification,the number of Ki-67 positive cells was about 5%. One year after surgery, the bone structure of the operation area recovered well and there were no signs of recurrence. Conclusion: AM can exist in a mixed-pattern of various pathological types, with millet-like Calcification occurring in the tumor interstitial. CBCT has a high sensitivity for detecting microcalcifications, and the detection rate of AM calcifications may be increasing, which requires heightened clinical attention. The invasiveness of single-cyst AM with mixed pathological types and interstitial calcification is not increased. Routine tumor curettage can achieve satisfactory treatment results.