Atypical presentation of a follicular adenomatoid odontogenic tumor in the left posterior Maxilla: a rare case report

The Adenomatoid Odontogenic Tumor (AOT) is a benign odontogenic neoplasm mostly found in young females in the anterior maxilla, often associated with an impacted canine. We report a rare follicular AOT associated with an impacted maxillary second premolar in a 35-year-old female. She presented with a slow-growing, asymptomatic enlargement of the left maxilla. Radiographic examination showed a 3.3 x 1.8 x 2.0 cm well-defined radiolucency with internal calcifications and associated with an impacted maxillary second premolar. Surgical enucleation with removal of the associated tooth was performed, maintaining the integrity of the maxillary sinus. Histopathological examination revealed typical duct-like structures overlaid by low columnar epithelial cells with polarized nuclei and focal eosinophilic enameloid substance. The present case represents a rare manifestation of follicular AOT that is not within the usual age range and anatomical location, highlighting the importance of radiographic and histopathological correlation in determining the proper course of action.