Ameloblastic Fibroma: Case Report and Review of Literature

Abstract

Introduction

The ameloblastic fibromas is a rare mixed odontogenic tumor composed of epithelial and mesenchymal tissue. The lesion was first described by Krause in 1891. Ameloblastic fibroma usually occur in the first two decades of life with a slight female predilection and is frequently found in the posterior region of the mandible and is often associated with an unerupted tooth.

Materials and Methods

A 8 year old male with past medical history of asthma presented to the pediatric dental clinic. On routine examination a large unilocular radiolucency under tooth #T was noted. Patient was referred to the oral surgery clinic for evaluation where a panoramic radiograph was taken and tooth #29 was noted to be inferior displaced. Further imaging with CBCT showed a well circumscribed mandibular right lesion associated with impacted tooth #29, tooth #29 was displaced inferiorly and the lesion extended horizontally from primary tooth #S to mesial of root of tooth #30, there appeared to be resorption of roots of tooth #T, no obvious cortical perforation was noted. Clinical differential diagnosis included: dentigerous cyst, OKC, ameloblastoma, aneurysmal bone cyst, giant cell lesion.

After negative fine needle aspiration an incisional biopsy was conducted under IV sedation. The incisional biopsy of the cystic tissue lining was sent to pathology for interpretation.

Results

Based on histological analysis the entity was diagnosed as ameloblastic fibroma. Treatment for the lesion was extraction of teeth #29,30, excisional biopsy and enucleation and curettage. Final pathology result after excisional biopsy confirmed diagnosis of ameloblastic fibroma.

Conclusion

Ameloblastic fibroma is an uncommon mixed odontogenic tumor. Practitioner should be aware that ameloblastic fibromas do have the potential for recurrence and malignant transformation. Of concern is transformation to ameloblastic fibrosarcoma which have occurred in sites of previously diagnosed ameloblastic fibromas. Prolonged periods of follow-up are essential.