The major remaining gap in our current knowledge of adenomatoid odontogenic tumor (AOT) includes its recurrence potential [
10,
11]. Among more than 1,082 cases reported [
11], there were only two publications of unequivocal AOT with recurrence [
12,
13]. The 2004 literature review concluded that the reportedly recurrent AOT are almost certainly AAD [
10,
14]. Although the diagnostic nosologic problem remains, the term AAD is applied to a rare plexiform ameloblastoma with microscopic features of AOT including duct-like structures and dentinoid deposition [
10]. As shown in the present and previous cases [
15], the final diagnosis of AAD was made only in retrospect, after multiple recurrences. It is imperative to understand that AAD is actually an ameloblastoma with propensity for infiltration and recurrence. Clinical and pathologic correlation is important to avoid misdiagnosis. In brief, AAD contrasts with AOT by tending to occur in an older age group and to appear as an ill-defined, extrafollicular radiolucency and encapsulation is less apparent in AAD [
14‐
16]. Good examples of this dilemma have occasionally been reported [
17‐
19]. Microscopically, immunopositivity for calretinin may be a rationale for the ameloblastoma nature [
9,
20], as evident in our AAD. The surgical pathologists should keep AAD in mind as a new diagnostic pitfall of AOT [
10].