Nickan Research Institute Immunopathologia Persa 2423-8015 12 1 2026 01 01 Successful surgical management of acanthomatous ameloblastoma with extensive mandibular involvement; a rare case report e43993 e43993 10.34172/ipp.2025.43993 EN Arash Sarrafzadeh https://orcid.org/0000-0003-0026-6821 Parto Nasri https://orcid.org/0000-0002-9596-8860 Salar Nasr Esfahani https://orcid.org/0000-0003-2290-3588 Maryam Mohebiniya https://orcid.org/0000-0001-6691-0128 Soheila Jadidi https://orcid.org/0000-0002-7307-6108 Journal Article 10.34172/ipp.2025.43993 2025 09 04 2025 11 29 Ameloblastoma is the most common benign odontogenic epithelial tumor, accounting for approximately 11–18% of all odontogenic neoplasms and 1-3% of all oral cysts and tumors. It primarily affects the posterior mandible and usually arises in the third to fifth decades of life. Despite its slow growth, this tumor is locally aggressive and may metastasize or undergo malignant transformation. Histologically, ameloblastoma comprises several variants. The acanthomatous variant, although relatively rare, is characterized by squamous metaplasia and keratin formation within the central stellate reticulum-like cells of the tumor islands. The clinical and radiographic characteristics of ameloblastoma are often nonspecific and may resemble other multilocular radiolucent lesions. Accurate diagnosis necessitates the integration of advanced radiographic imaging, particularly cone-beam computed tomography, along with definitive histopathologic evaluation. We presented a rare case of acanthomatous ameloblastoma affecting both the anterior and posterior regions of the left mandible in a 33-year-old male with a five-year history of jaw expansion and progressive tooth mobility, along with its surgical management. The lesion showed extensive anterior extension, crossing the midline. This case underscores the significance of comprehensive differential diagnosis and histopathological confirmation in managing unusual presentations of ameloblastoma.