Large ameloblastic fibro-odontoma in an 18-year-old girl and review of literature

Abstract

The ameloblastic fibro-odontoma is a rare, benign, mixed neoplasm composed of proliferating odontogenic epithelium, ectomesenchymal tissue and varying degrees of dental hard tissue formation. It occurs exclusively as an intraosseous lesion. It usually exhibits slow growth and is commonly seen in children and young adults. Radiologically, ameloblastic fibro-odontoma appears as a circumscribed radiolucency which may contain radiopaque foci. Most cases of ameloblastic fibro-odontoma exhibit benign behaviour, but cases of malignant transformation have been reported. The treatment modality in most cases involves conservative surgery, but in cases with malignant transformation more radical treatment will be required. A massive ameloblastic fibro-odontoma involving the mandible is being described here with its clinical, radiological and histopathological features.

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

“…The reported articles revealed a few cases of AFO that involved the maxilla [14,15]. According to most literature, AFO is a non-aggressive lesion [1,5]. Contrary to these findings, however, our case has the destruction of the left hard palate and orbital rim.…”

“…This makes our case rare since the patient in the current case presentation was 21 years old. Most of the reported case series showed no sex predilection [1]. However, in the aforementioned literature review of 108 cases, the male-to-female ratio was 1.62:1.…”

“…The abstract of this article was previously presented at the College of American Pathologist meeting, Chicago, September 25-28, 2021. Ameloblastic fibro-odontoma (AFO) is a benign mixed odontogenic neoplasm that is to hamartoma [1]. In the latest World Health Organization (WHO) classification of head and neck tumors, AFO is classified as developing odontomas rather than a distinct tumor [2].…”

Ameloblastic fibro-odontoma located in the maxilla of a 3-year-old girl

“…In conclusion, the authors would like to contribute this unusual case of a young girl to further the knowledge regarding this odontogenic tumor, to recommend a conservative surgical management and a regular follow-up protocol for at least two years to rule out any evidence of recurrence or the rare malignant transformation [11,19,27].…”

“…Interestingly, patients coming from countries such as India [19,20] or South America [11,21,22] present to dentists often at teenage or adult age whereas in countries such as Germany [23,24] or Switzerland, tumors are detected much earlier. An important explanatory reason may be the fact that the latter countries have well developed health care systems and dental examinations are offered in early childhood.…”