Mandible / maxilla – Malignant tumors: ameloblastic fibrosarcoma. A case of an ameloblastic fibrosarcoma in the mandible is described. The primary tumor was seen in a 5-year-old child. In spite of repeated surgical. Introduction. Ameloblastic fibrosarcoma (AFS) is a rare malignant odontogenic tumor. It can arise de novo, however one-third of cases may arise from a recurrent.
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Resection with a wide margin is the optimal treatment strategy and close follow-up is advised due to its relatively high recurrence rate. Home About Us Advertise Amazon.
Ameloblastic Fibrosarcoma of the Mandible: A Case Report and Brief Review of the Literature
The patient underwent a left hemimandibular resection. Failure to correctly evaluate the panoramic radiographs and establish a clinical differential swrcoma by the general practitioner should be given special attention.
Both neoplasms have a biphasic nature; however, AF has no malignant component, unlike AFS in which the mesenchymal component presents marked cellularity, nuclear pleomorphism, hyperchromatism, and a moderate to high number of mitotic figures.
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Her age at presentation was 22 years old, a little younger than the mean age of presentation, but still in the third decade of life, like most patients from previous reports. Anaplastic ameloblastic fibrosarcoma arising from recurrent ameloblastic fibroma: Computerized tomography CT sarcom showed a large destructive mass. At the center of these islands is polyhedral cell reminiscent of stellate reticulum.
The histological architecture of AFS is characterized by benign epithelial islands that are composed of columnar or cuboidal peripheral cells arranged in a palisading pattern.
Malignant transformation of ameloblastic fibroma to ameloblastic fibrosarcoma: In general, the fibrk of choice is surgical excision with clear margins and long-term follow-up. Only 2 cases of metastasis have been reported [ 1516 ]. Gross photograph of the cut surface of the left half of the mandible showing a solid gray tumor mass. In view of these histopathological and immunohistochemistry findings, an AFS ameloblasyic diagnosed.
Currently, one year after the surgical procedure, the patient is clinically and radiologically disease-free Figure 7. The patient was under close follow up and after 6 months, rehabilitative prosthetic treatment was started.
Surgical resection with a wide margin is the optimal treatment strategy Adjuvant chemotherapy and radiotherapy as needed; may reduce the recurrence rate and enhance the quality of life. Maryam Khalili 1 and Pouyan Amini Shakib 2. Due to lack of experience, there is no amelkblastic on the treatment yet. The usual clinical presentation consists of a patient who complains of a painful but occasionally painless facial mass with accompanying szrcoma or dysesthesia.
No other intra- or extra-oral sign was amellblastic the remaining head and neck examination and general physical evaluation were unremarkable and no significant event was noted in the medical history. Nil Conflict of Interest: Assessment of growth potential by MIB-1 immunohistochemistry in ameloblastic fibroma and related lesions of the jaws compared with ameloblaetic fibrosarcoma.
Treatment of choice is wide surgical excision, with long-term follow-up. Odontogenic Tumors and Allied Lesions. AFS was first reported by Heath in describing it as a spindle cell sarcoma that also had epithelial cells resembling the cells of the enamel organ [ 5 ].
Ameloblastic fibrosarcoma: a rare malignant odontogenic tumor.
Intraorally, nontender buccal and palatal expansion of the alveolar ridge at the same area was observed. Computed tomography scan showed extension of the lesion medially and vertically to the nasal septal bone and the inferior orbital rim, respectively [ Figure 2 ].
Support Center Support Center. Therefore, some investigators recommend a more aggressive treatment for ameloblastic fibromas as compared to previous procedures. Also, the extraction site of the second and third molar was filled with an irregular exophytic ulcerated mass which bled easily on palpation [ Figure 1 ].
Malignant odontogenic tumors are classified as odontogenic carcinomas and odontogenic sarcomas [ 1 ].
Ameloblastic fibrosarcoma AFS is a malignant odontogenic tumor characteristically composed of a benign epithelium and a malignant mesenchymal component [ 2 ]. We also emphasize on comprehensive clinical, radiographic, and histopathologic evaluation of such patients rather than immunohistochemical staining to make an accurate diagnosis. Although AFS is regarded as the malignant counterpart of ameloblastic fibroma, it may arise de novo without any pre-existing lesion.
After 2 years follow up, no evidence of recurrence was noted. Lectures on certain diseases of the jaws.
CD34 expressing ameloblastic fibrosarcoma arising in the maxilla: Panoramic radiograph showing area of mandibular resection with amellblastic evidence of recurrence 1 year after surgery. Radiographs show a radiolucent mass with ill-defined borders.
National Center for Biotechnology InformationU. Restricted molecular abnormalities of certain genes to the ameloblastoc transformation. Diagnosis dependent on clinical, radiologic and pathologic correlation.
Discussion AFS was first reported by Heath in describing it as a spindle cell sarcoma that also had epithelial cells resembling the cells of the enamel organ [ 5 ]. Adjuvant radiotherapy has been used with no fihro of recurrence [ 9 ].
Computed tomography scan shows extensive destruction of the left maxillary sinus.