Classification[ edit ] An ameloblastic fibroma is classified by The World Health Organisation as a benign mixed odontogenic tumour 1. It develops from the dental tissues that grow into teeth. During human development, embryonic cells of ectoderm and mesenchyme produce epithelial and ectomesenchyme tissues. These proliferate and mature into ameloblasts and fibrous connective tissue 3 , and ultimately teeth. Ameloblastic fibromas contain both of these tissues, and its name is derived from them.
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E-mail: moc. This article has been cited by other articles in PMC. Abstract Ameloblastic fibroma is a rare odontogenic tumor comprising neoplastic epithelial and mesenchymal tissues. This lesion was previously considered to be a benign lesion with very limited recurrence rate and malignant transformation.
However, recent reports have suggested that this lesion has the potential for recurrence and malignant transformation. In this brief report, we report a case of AF in the context of its high cellularity on histopathological examination. AF was first described by Krause in Small tumors are asymptomatic, while larger ones produce significant swelling of the jaws.
On radiographs, smaller lesions are well circumscribed and unilocular with a sclerotic border, while larger ones are multilocular. Histopathologically, AF consists of odontogenic epithelium in the dental papilla-like background without dental hard tissue formation. Recently, there are few reports of this condition with high recurrence rates and malignant transformation. Patient had identified the enlargement 8 months back and her medical history was unremarkable.
On intraoral examination, the right lower buccal vestibule was obliterated due to the expansion of the buccal cortical plate. The mucosa over the swelling was normal, except for slight blanching due to expansion of the buccal cortical plate. The lesion is seen extending from posterior aspect of first molar to the retromolar area, measuring 3 cm in size.
On palpation, the swelling was slightly tender and no abnormality was detected in the adjacent teeth. Panoramic radiograph showed a unilocular radiolucent area with well-defined borders, involving the posterior aspect of the right mandible.
The lesion was measuring approximately 3. Inferiorly, the lesion was extending till the mandibular canal. Fine needle aspiration did not yield any fluid ruling out a cystic lesion.
The lesion was enucleated and sent for histopathological examination. Microscopically, hematoxylin and eosin sections showed islands and strands of epithelial cells in a loose connective tissue stroma resembling primitive dental papilla [ Figure 1 ]. The peripheral epithelial cells lining the islands and strands were low columnar, similar to the cells found in the peripheral layer of the follicle in ameloblastoma. The connective tissue resembled cellular fibroblastic tissue similar to the dental papilla in the developing tooth.
Hyaline-like tissue is also seen adjacent to the epithelial strands and islands [ Figure 2 ]. It was interesting to note that both the epithelial islands and connective tissue stroma revealed high cellularity when compared with the conventional lesions of AF. However, severe dysplastic features such as cellular and nuclear pleomorphism and increased number of abnormal mitotic figures were not observed.
In this context, immunohistochemistry for Ki [ Figure 3a ] proliferative marker along with proper positive [ Figure 3b ] and negative [ Figure 3c ] controls were performed.
Immunohistochemistry for Ki was negative as it was not taken up by the tissue. This had ruled out the diagnosis of a malignant tumor, confirming the diagnosis of AF.
Ameloblastic Fibroma Mimicking Dentigerous Cyst: A Diagnostic Dilemma
Stomach Cancer Ameloblastic Fibroma Symptoms, Causes, Treatment At the early stage of life, the oral cavity may undergo some changes which majorly involve the eruption and regrowth of all the teeth. Meanwhile, during the happening of this natural process, several abnormalities can be observed in a few cases. For example, in some cases the eruption of teeth may not complete and the piece of any un-erupted teeth, a whole un-erupted tooth, delayed eruption, alteration in this specified series of dental eruption may lead to the adoption of some seriously dangerous disease tumors. In this condition, the vulnerable sites are the mandible and maxilla of the oral cavity. The dental enamel or lamina dentin consists of ameloblastic tissues which may lead to the growth of the odontogenic cyst from their lining resulting in the ameloblastic fibroma. What is Ameloblastic Fibroma? Ameloblastic fibroma is an extremely rare neoplasm that is characterized by the odontogenic cyst growing from the dental enamel or lamina dentin in the oral cavity.
Husain J. Mograwala, Room No. E-mail: moc. Abstract Ameloblastic fibroma is a rare, slow-growing odontogenic mixed tumor with neoplastic epithelial and ectomesenchymal tissue, which does not show inductive changes to form enamel and dentin. It is frequently found in the first two decades of life. It is often confused with ameloblastoma and dentigerous cyst due to the presence of an impacted tooth and can be distinguished histologically.
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