Ameloblastic fibrosarcoma of the upper jaw: Report of a rare case with long-term follow-up

Abstract

Ameloblastic fibrosarcoma (AFS) is a rare malignant mixed odontogenic tumor which is usually considered as the malignant counterpart of ameloblastic fibroma. Only mesenchymal component represents sarcomatous alterations and ameloblast-like epithelial nest remains bland in AFS. Here, we report a case of AFS in a 26-year-old man in the maxilla, which was regarded as an uncommon location for this tumor. After 2 years follow up, no evidence of recurrence was noted. We also emphasize on comprehensive clinical, radiographic, and histopathologic evaluation of such patients rather than immunohistochemical staining to make an accurate diagnosis.

Keywords: Ameloblastic fibrosarcoma; maxilla; odontogenic tumor.

Figure 1

Intraoral view shows buccal and palatal expansion in the left maxillary region and the exophytic ulcerated mass

Figure 2

Computed tomography scan shows extensive destruction of the left maxillary sinus

Figure 3

Photomicrographs showing (a) benign-appearing epithelial islands and highly cellular mesenchymal component (H and E, original magnification ×100); (b) pleomorphism and scattered bizarre cells in mesenchymal component (H and E, original magnification ×100)

Figure 4

Intraoral examination and (a) CT scan evaluation (b) revealed no evidence of recurrence after two years

Figure 5

Age and gender distribution of 68 cases of Ameloblastic fibrosarcoma (age or gender of three cases of 71 reported AFSs have not been specified)