Ameloblastic fibroodontoma (AFO) is a rare entity of mixed odontogenic tumors and frequently arises from posterior portion of the maxilla or mandible in first two decades of life. Herein, a 35-year-old woman with a noncontributory medical history who presented with a progressive left maxillary toothache, left maxillary first molar tooth mobility, and swelling in the left maxillary molar area for the last 2 months was reported. Radiologically, a tumor that originated from periapical area of the second mature molar teeth of maxilla was seen and additively unerupted tooth was not detected. The histopathologic examination revealed AFO. The patient is disease-free for five years after treated with limited segmental alveolectomy combining with Caldwell-Luc procedure.
Ameloblastic fibroodontoma (AFO) is an uncommon mixed odontogenic tumor of odontogenic epithelium and mesenchyme origin [
A 35-year-old female presented with a 2-month history of progressive left maxillary toothache, left maxillary first molar tooth mobility, and swelling in the left maxillary molar area. There was no history of chronic nasal problems or odontogenic surgery. Swelling on the left side of the maxillary alveolar arch was revealed by intraoral inspection. The rest of the ENT examination was unremarkable. Preoperative oral panoramic radiograph (OPR) and computer tomography imaging (CTI) of the paranasal sinus revealed a radiolucent expansive lesion containing multiple radiopaque foci on the left side maxillary sinus (Figure
(a) Preoperative OPR showing a radiopaque mass with a radiolucent border in the left upper jaw. (b, c, d) Preoperative CTI showing a radiolucent expansive lesion containing multiple radiopaque foci on the left side maxillary sinus.
(a) Ameloblastic epithelium in the fibroblastic stroma (H&E ×20). (b) Odontogenic epithelium forming premature tooth like pattern (H&E ×10). (c) Odontogenic epithelium forming material consistent with dentine (H&E ×10). (d) Calcific zones surrounded with dentine (H&E ×10). (e) Focal zones consistent with cementifying changes (H&E ×20).
(a, b, c) Respectively, axial T2, coronal T1, and coronal T2 postoperative MRI showing mucosal thickening in the maxillary without any evidence of tumor recurrence.
Ameloblastic fibroodontoma is a rare entity of mixed odontogenic tumors and frequently arises from posterior portion of the maxilla or mandible in first two decades of life [
Asymptomatic slow growth swelling and delayed tooth eruptions are the most common symptoms of AFO especially at early ages [
Radiological findings of the AFO were described in the previous studies. Dental like radiopaque foci surrounding well-defined radiolucent borders are the most detectable feature of AFO in radiological examinations [
The curative treatment of AFO involves enucleation or curettage. These approaches are frequently sufficient if the lesion is associated with unerupted teeth and the affected area is limited. In a small group of patients who have giant, extensive, and destructive disease, partial maxillectomy or segmental mandibulectomy may be needed [
In conclusion, AFO may also occur at advanced ages with odontogenic symptoms and the extension of lesion manages the curative treatment alternatives.
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The current address of Mustafa Aslıer, due to mandatory state work, is Silopi Devlet Hastanesi, Yenişehir Mah. 8 Cadde., No. 73, Silopi, Şırnak, Turkey.
None of the authors have any conflict of interests that could inappropriately influence (bias) the work.
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