Hybrid follicular–desmoplastic ameloblastoma of the anterior mandible presenting as a recurrent periapical lesion

Ameloblastoma is a locally aggressive odontogenic epithelial neoplasm, accounting for approximately 18% of odontogenic tumors. The coexistence of follicular architecture and desmoplastic stromal change within a single lesion represents a rare hybrid variant, reported in approximately 1.1% of cases and poses diagnostic and therapeutic challenges. A 58-year-old female presented with a 5-year history of progressively enlarging swelling in the lower anterior jaw, with prior root canal treatment providing only transient relief. Clinical and radiographic findings suggested an infected radicular cyst; however, histopathological examination of the excised specimen revealed follicular ameloblastoma with focal desmoplastic areas. The lesion was treated by complete surgical excision, and no recurrence was observed at a 1-year follow-up. This case emphasizes the critical role of histopathological evaluation in persistent jaw swellings and the importance of definitive management with long-term surveillance in rare hybrid variants.