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BACKGROUND: A rare combination of odontogenic lesions comprising of ameloblastoma and odontogenic keratocyst (OKC) has been reported among Asians and Caucasians. However, there is no report of similar association of both lesions among Africans in the English literature.
OBJECTIVE: This study reports a rare case of ameloblastoma associated with odontogenic keratocyst in a Nigerian female and highlights the related diagnostic challenges and treatment considerations.
CASE REPORT: A 26-years-old Nigerian female presented with a complaint of recurrent pain and blood-stained pus-like discharge from the left lower jaw of the patient which coincided with post-extraction site of a third molar tooth. A clinical diagnosis of chronic osteomyelitis was made. Antibiotics and analgesic were administered. Orthopantomogram of the mandible showed a left multilocular radiolucency with well-defined cortical border. Computed tomography (CT) scan showed anterio-posterior mandibular hypodense lesion extending from distal root of tooth number 37 (FDI numbering system) up to the level of zygmoid notch. An incisional biopsy was done and histological examination of the specimen revealed the presence of odontogenic keratocyst. A mandibular resection with disarticulation and immediate reconstruction under general anaesthesia was subsequently done for the patient. Post-surgical histological examination of serial sections of the lesion revealed a multicystic ameloblastoma. There was no recurrence after a follow-up period of 2 years. CONCLUSION: This report suggests a possible neoplastic transformation of OKC to ameloblastoma or a hybrid tumour consisting of ameloblastoma and OKC as both lesions are putatively from the remnant of dental lamina.