Misleading ameloblastomatoid and squamobasaloid rests growing within the nerve: a 100-year-old concept revisited

Objective

The jawbone contains a large number of unnamed epithelial rests that are remnants of the tooth-forming process. One of these uniquely extends naturally along neurovascular bundles, and was originally described at least 100 years ago as “epithelial nests in the bone nerve canal.” As this concept has been forgotten in the years since then, any association of epithelial rests with the nerve has remained diagnostically enigmatic.

Study Design and Results

In jawbone sections, we have found common resting squamobasaloid and rare proliferating ameloblastic nests within neurovascular bundles. The latter type of large organoid follicle, when viewed in isolation, closely resembles ameloblastoma, but notable immunohistochemical differences are evident, suggesting classification as ameloblastomatoid hyperplasia.

Conclusions

Recognition of challenging intraneural epithelial rests in marrow spaces within cancellous bone as a normal microanatomic finding may help prevent diagnostic confusion and misdiagnosis. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range)