A Locally Aggressive Ameloblastic Fibro-Odontoma: A Case Report and Literature Review

Abstract

Ameloblastic fibro-odontoma (AFO) is a relatively rare, benign noninvasive mixed odontogenic neoplasm derived from epithelial and ectomesenchymal elements of the dental tissues. It usually presents with a mean age of 11.5 years and in the posterior segment of the mandible. It is extremely rare in the posterior maxilla. Although the latest WHO edition classified AFO as developing odontoma, here we present a locally aggressive AFO in a 21-year-old male involving the posterior maxilla and sinus with bone destruction. The patient presents with a two-year history of slowly progressive left facial swelling with malodorous drainage. The CT scan revealed a 5.5 x 4.3 cm well-circumscribed expansile mass with mixed attenuation and peripheral calcification occupying the left maxilla and sinus with bone destruction of the hard palate and orbital rim. According to the literature, most of the AFO cases were treated adequately through a conservative approach with just enucleation or surgical curettage. To our knowledge, our case is the first case treated aggressively with left maxillectomy, palatectomy, and reconstruction surgery because of its radiologic findings, which suggested a locally invasive neoplasm. Histologically, the specimen showed a mixture of proliferative epithelial, mesenchymal tissue elements, and variable amounts of mineralized deposits consisting of enamel matrix and dentinoid deposits, and the final diagnosis was AFO. In conclusion, we present a rare case of AFO with an unusual aggressive presentation, age group, and site involved. The radiographic, histopathologic features, and therapeutic approaches of this unusual locally aggressive tumor are presented with the review of relevant literature.

ChatGPT Guided Diagnosis of Ameloblastic Fibro-Odontoma: A Case Report with Eventful Healing

“…• The integration of AI in dentistry increases diagnostic accuracy and improves clinicopathologic correlation, representing a significant advancement in the field removal of the tumor, curettage, and extraction of the associated teeth [8]. Most recurrences reported in the literature are the result of inadequate removal, therefore surgical planning is critical [8].…”

“…Its higher prevalence is particularly observed in the pediatric population [6]. AFO exhibits less aggressive behavior than AF although numerous case reports have documented locally aggressive involvement of AFO [7][8][9]. Treatment varies from only the removal of the tumor to the…”

Ameloblastic Fibro-Odontoma of the Posterior Mandible: A Rare Pathological Entity

“…This is typically resolved by relying on observations obtained from a presurgical biopsy performed under local anesthesia. Consequently, clinical diagnosis assumes an exceedingly significant role in the preemptive delineation of surgical procedures, particularly with regard to determining the feasibility of conserving teeth situated in close proximity to the lesion [ 5 ]. The purpose of this paper is to report a clinical case of ameloblastic fibroodontoma (AFO) in an 18-year-old individual with a lesion involving the posterior mandible that was managed through surgical enucleation.…”

Ameloblastic fibro‑odontoma in the posterior mandible: A case report

“…This is typically resolved by relying on observations obtained from a presurgical biopsy performed under local anesthesia. Consequently, clinical diagnosis assumes an exceedingly prominent role in the preemptive delineation of surgical procedures, particularly as regards the determination of the feasibility of conserving teeth situated in close proximity to the lesion (5).…”