The Silent Swell in the Anterior Maxilla: Unmasking a Peripheral Ameloblastoma

Abstract

Peripheral ameloblastoma is a rare extraosseous odontogenic tumour arising from the soft tissues overlying tooth-bearing regions of the jaws. In contrast to the conventional intraosseous ameloblastoma, this variant demonstrates relatively indolent biological behaviour and minimal invasive potential. Due to its innocuous clinical appearance and similarity to common reactive gingival lesions, peripheral ameloblastoma often presents a diagnostic challenge in clinical practice. This report presents a rare case of peripheral ameloblastoma involving the anterior palatal mucosa in a 44-year-old male patient who presented with a painless swelling that gradually increased in size over six months. Clinical examination revealed a firm sessile mass measuring approximately 2.5 × 1.5 cm extending from tooth 21 to 13 along the palatal mucosa. Radiographic investigations, including periapical radiography, maxillary occlusal imaging, and cone beam computed tomography, revealed no evidence of underlying osseous involvement. The lesion was surgically excised under local anaesthesia, and histopathological examination demonstrated classical follicular architecture with peripheral palisading and reverse polarization consistent with peripheral ameloblastoma. Postoperative healing was uneventful, and no recurrence was observed during a 12-month follow-up period. The present case highlights the importance of considering peripheral odontogenic tumours in the differential diagnosis of persistent palatal swellings. Early diagnosis and conservative surgical excision remain the mainstay of management with a favourable prognosis.