Ameloblastic fibroma with ghost cell differentiation and calcification: A unique case report

Arora, Asit; Dave, Aparna; Shetty, Vishwaprakash; Saluja, Pulin

doi:10.4103/0973-1482.150436

Cited by 3 publications

(8 citation statements)

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“…Most of the conventional AF/AFOs are associated with impacted teeth and unilocular radiolucencies (2,4), which is almost identical to the results found in this study. In this systematic review, some hybrid tumors showed huge sizes and destructive lesions (1,7,9), which support the tumoral nature of these lesions. It has been suggested by a number of researchers that hybrid tumors are not two separate lesions but are related to the multi-potential nature of the odontogenic epithelium (10,16).…”

Section: Discussionsupporting

confidence: 67%

“…Typical AF is slightly more common in males (2,4). AF/AFO tend to occur in the first two decades of life and in the posterior region of the mandible (1,2,4). The mean age of patients with rare variants of AF/AFO in our study was 13.75 years and the commonest location was the posterior region of the mandible, which is similar to the conventional type.…”

Section: Discussionmentioning

confidence: 99%

“…Ameloblastic fibroma (AF) is an uncommon benign odontogenic neoplasm, which is described by the proliferation of both the odontogenic epithelium and the mesenchyme. Ameloblastic fibro-odontoma (AFO) is demarcated as a lesion with the microscopic structures of an AF that also contains dental structures, namely dentine and enamel (1,2). Some researchers have designated that when only dentin matrix and dentinoid material is produced, the lesion should be called ameloblastic fibro-dentinoma (AFD) (2).…”

Section: Introductionmentioning

confidence: 99%

“…Radiographically, AF shows either a unilocular or a multilocular radiolucency, both with well-defined borders. AFO contains a variable amount of calcified material with the radiodensity of tooth structures (1,2,4). The treatment of choice for these lesions is a conservative excision.…”

Section: Introductionmentioning

confidence: 99%

“…Recurrence is uncommon and they might have a potential for malignant transformation (4,5). Rarely, AF/AFO are associated with other odontogenic cysts and tumors or show rare microscopic changes (1,4,6-15). The aim of this systematic review is gathering data about unusual variations of these tumors and discussing their clinical, radiographic and histopathologic features.…”

Section: Introductionmentioning

confidence: 99%

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Unusual microscopic changes of Ameloblastic Fibroma and Ameloblastic Fibro-odontoma: A systematic review

Atarbashi-Moghadam¹,

Ghomayshi²,

Sijanivandi³

2019

J Clin Exp Dent

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Background Ameloblastic fibroma (AF) and ameloblastic fibro-odontoma (AFO) are uncommon benign mixed odontogenic neoplasms. Although unusual microscopic changes including hybrid tumors have been documented in publications, their clinical outcome prediction and treatment modality selection are still challenging due to scarcity. Objective: Analysis of AF/AFO’s unusual microscopic variants in order to improve histopathologic diagnosis and to help clinicians in making informed treatment choices. Material and Methods An electronic search was performed in PubMed’s database using keywords: “ameloblastic fibroma”, “ameloblastic fibroodontoma”, “ameloblastic fibro-odontoma”. The search scheme was limited to articles in English, dated ‘January 1998’ to ‘October 2018’, with full texts (case reports and series) and human studies. Eligibility criteria included publications having enough clinical, radiological, and histological data to confirm their diagnosis. Age, sex, lesions’ location, radiologic features, signs, symptoms, treatment approaches, and recurrences were recorded and analyzed. Results In this systematic review, 11 articles (reporting 14 cases) were selected. Patients’ mean age was 13.75 years (male/female = 1.8). The posterior region of the mandible was the lesions’ commonest location (57.14%). Swelling was reported in 78.57% of the cases, pain in 28.57% but 21.42% were asymptomatic. Radiolucent unilocular appearance was the commonest radiographic feature, but 28.57% of the cases showed a mixed radiolucent-radiopaque appearance. Other reported radiographic findings were impacted tooth (78.57%), root resorption (28.57%), tooth mobility (35.71%), and cortical perforation (14.28%). No recurrences were reported. Calcifying odontogenic cyst (COC) was the commonest lesion associated with AF/AFO (53.33%). Unicystic ameloblastoma and cystic changes without prominent epithelial lining were other reported hybrid lesions. Reported microscopic variations were pigmentation and ghost cell differentiation. Conclusions COC was the commonest lesion associated with AF/AFO. Although COC commonly occurs in the jaws’ anterior region, hybrid cases were more common in the posterior area. No malignant transformations were reported. The treatment modality is mostly chosen based on the lesion’s most aggressive part. Key words: Ameloblastic fibroma, Ameloblastic fibro-odontoma, Odontogenic tumor, Jaw.

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