An Unusual Presentation of “Two-Thirds Tumor” in the Mandible – A Diagnostic Quandary with a Review of the Literature

An adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of the oral cavity commonly found in the maxillary anterior region and is associated with impacted canines in young females. It rarely occurs in the mandibular region with no impacted or missing teeth. A 21-year-old female reported to the clinic with swelling on the right side of the face for the past six months with no history of pain. Radiographic features such as unilocular radiolucency with thinning of the cortical borders and considerable buccal cortical expansion, as well as some evidence of radiopaque specks were noted. Histopathological examination revealed cells with hyperchromatic nuclei, rosette-like structures with focal areas of calcified mass, and concentric rings resembling Liesegang rings, suggestive of AOT. The tumor was treated surgically by enucleation and cauterization. Although follicular type is a common variant, the tumor presented in this case was of extrafollicular type noted in the mandibular canine and premolar regions of a young female patient with no related impacted tooth.