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Ameloblastic fibrosarcoma of the mandible: a case report and brief review of the literature.

Loya-Solis A, González-Colunga KJ, Pérez-Rodríguez CM, Ramírez-Ochoa NS, Ceceñas-Falcón L, Barboza-Quintana O - Case Rep Pathol (2015)

Bottom Line: Radical surgical excision and long-term follow-up are the suggested treatment.Examination revealed an exophytic growth measuring 3 × 3 cm extending from the mandibular left first premolar to the second molar.Histopathological examination revealed a biphasic tumor composed of inconspicuous islands of benign odontogenic epithelium and an abundant malignant mesenchymal component with marked cellularity, nuclear pleomorphism, hyperchromatism, and moderate mitotic figures with clear margins; one year after the surgical procedure, the patient is clinically and radiologically disease-free.

View Article: PubMed Central - PubMed

Affiliation: Pathology Department, University Hospital "Dr. Jose E. Gonzalez" and Medical School of the Autonomous University of Nuevo Leon, Francisco I. Madero and Gonzalitos, 64460 Monterrey, NL, Mexico.

ABSTRACT
Ameloblastic fibrosarcoma is an uncommon odontogenic tumor composed of a benign epithelial component and a malignant ectomesenchymal component most frequently seen in the third and fourth decades of life. It mainly presents as a painful maxillary or mandibular swelling. Radiographs show a radiolucent mass with ill-defined borders. Radical surgical excision and long-term follow-up are the suggested treatment. We report the case of a 22-year-old female with a 2-month history of an asymptomatic swelling in her left mandible. Examination revealed an exophytic growth measuring 3 × 3 cm extending from the mandibular left first premolar to the second molar. The patient underwent a left hemimandibular resection. Histopathological examination revealed a biphasic tumor composed of inconspicuous islands of benign odontogenic epithelium and an abundant malignant mesenchymal component with marked cellularity, nuclear pleomorphism, hyperchromatism, and moderate mitotic figures with clear margins; one year after the surgical procedure, the patient is clinically and radiologically disease-free.

No MeSH data available.


Related in: MedlinePlus

Panoramic radiograph showing area of mandibular resection with no evidence of recurrence 1 year after surgery.
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fig7: Panoramic radiograph showing area of mandibular resection with no evidence of recurrence 1 year after surgery.

Mentions: Four months later a panoramic radiograph and CT scan of head and neck were performed disregarding locoregional and distant metastases while also revealing again the same ill-defined radiolucent lesion around an impacted mandibular left first molar (Figure 4). The patient underwent a left hemimandibular resection and immediate fibular free flap reconstruction. The excised specimen consisted of the left half of the body and ramus of the mandible measuring 5 × 4.2 × 3 cm with a gray solid tumor mass of 1.8 cm with widely clear margins (Figure 5). Histopathological examination showed the same biphasic tumor previously described. Additional immunohistochemistry was performed using PCNA and p53 (Figure 6). PCNA was strongly positive in both components, while p53 was strongly positive only in the mesenchymal component. The final histopathological diagnosis was identical to that of the incisional biopsy and an AFS was confirmed. Currently, one year after the surgical procedure, the patient is clinically and radiologically disease-free (Figure 7).


Ameloblastic fibrosarcoma of the mandible: a case report and brief review of the literature.

Loya-Solis A, González-Colunga KJ, Pérez-Rodríguez CM, Ramírez-Ochoa NS, Ceceñas-Falcón L, Barboza-Quintana O - Case Rep Pathol (2015)

Panoramic radiograph showing area of mandibular resection with no evidence of recurrence 1 year after surgery.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4377457&req=5

fig7: Panoramic radiograph showing area of mandibular resection with no evidence of recurrence 1 year after surgery.
Mentions: Four months later a panoramic radiograph and CT scan of head and neck were performed disregarding locoregional and distant metastases while also revealing again the same ill-defined radiolucent lesion around an impacted mandibular left first molar (Figure 4). The patient underwent a left hemimandibular resection and immediate fibular free flap reconstruction. The excised specimen consisted of the left half of the body and ramus of the mandible measuring 5 × 4.2 × 3 cm with a gray solid tumor mass of 1.8 cm with widely clear margins (Figure 5). Histopathological examination showed the same biphasic tumor previously described. Additional immunohistochemistry was performed using PCNA and p53 (Figure 6). PCNA was strongly positive in both components, while p53 was strongly positive only in the mesenchymal component. The final histopathological diagnosis was identical to that of the incisional biopsy and an AFS was confirmed. Currently, one year after the surgical procedure, the patient is clinically and radiologically disease-free (Figure 7).

Bottom Line: Radical surgical excision and long-term follow-up are the suggested treatment.Examination revealed an exophytic growth measuring 3 × 3 cm extending from the mandibular left first premolar to the second molar.Histopathological examination revealed a biphasic tumor composed of inconspicuous islands of benign odontogenic epithelium and an abundant malignant mesenchymal component with marked cellularity, nuclear pleomorphism, hyperchromatism, and moderate mitotic figures with clear margins; one year after the surgical procedure, the patient is clinically and radiologically disease-free.

View Article: PubMed Central - PubMed

Affiliation: Pathology Department, University Hospital "Dr. Jose E. Gonzalez" and Medical School of the Autonomous University of Nuevo Leon, Francisco I. Madero and Gonzalitos, 64460 Monterrey, NL, Mexico.

ABSTRACT
Ameloblastic fibrosarcoma is an uncommon odontogenic tumor composed of a benign epithelial component and a malignant ectomesenchymal component most frequently seen in the third and fourth decades of life. It mainly presents as a painful maxillary or mandibular swelling. Radiographs show a radiolucent mass with ill-defined borders. Radical surgical excision and long-term follow-up are the suggested treatment. We report the case of a 22-year-old female with a 2-month history of an asymptomatic swelling in her left mandible. Examination revealed an exophytic growth measuring 3 × 3 cm extending from the mandibular left first premolar to the second molar. The patient underwent a left hemimandibular resection. Histopathological examination revealed a biphasic tumor composed of inconspicuous islands of benign odontogenic epithelium and an abundant malignant mesenchymal component with marked cellularity, nuclear pleomorphism, hyperchromatism, and moderate mitotic figures with clear margins; one year after the surgical procedure, the patient is clinically and radiologically disease-free.

No MeSH data available.


Related in: MedlinePlus